Provider Demographics
NPI:1659544104
Name:MELAMED, RIMMA (RPH)
Entity Type:Individual
Prefix:
First Name:RIMMA
Middle Name:
Last Name:MELAMED
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2064 CROPSEY AVE APT 3B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-6208
Mailing Address - Country:US
Mailing Address - Phone:917-771-4883
Mailing Address - Fax:
Practice Address - Street 1:2064 CROPSEY AVE APT 3B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-6208
Practice Address - Country:US
Practice Address - Phone:917-771-4883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY28RI02590900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist