Provider Demographics
NPI:1619517471
Name:SALAZAR, MELINA ISABEL (RN)
Entity Type:Individual
Prefix:
First Name:MELINA
Middle Name:ISABEL
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:552 MARCY AVE APT 3D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-5636
Mailing Address - Country:US
Mailing Address - Phone:347-661-3322
Mailing Address - Fax:
Practice Address - Street 1:110 E 107TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-3904
Practice Address - Country:US
Practice Address - Phone:212-860-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY781645163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse