Provider Demographics
NPI:1659334035
Name:MELCHIONNO, STEVEN SAVERIO (MPT, OCS)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:SAVERIO
Last Name:MELCHIONNO
Suffix:
Gender:M
Credentials:MPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:83 HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-5506
Mailing Address - Country:US
Mailing Address - Phone:203-595-2905
Mailing Address - Fax:
Practice Address - Street 1:83 HARVARD AVE
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-5506
Practice Address - Country:US
Practice Address - Phone:203-595-2905
Practice Address - Fax:203-487-0029
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0073252251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1659334035OtherMEDICARE PNI