Provider Demographics
NPI:1689182198
Name:CAMURATI, MELANIE
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:CAMURATI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ADRIEN
Other - Middle Name:
Other - Last Name:CAMURATI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7311 217TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-2933
Mailing Address - Country:US
Mailing Address - Phone:917-991-4398
Mailing Address - Fax:
Practice Address - Street 1:4621 COLDEN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-4134
Practice Address - Country:US
Practice Address - Phone:718-353-0009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-18
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027399235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist