Provider Demographics
NPI:1730481185
Name:SHIH, MELANIE W (OMD, LAC)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:W
Last Name:SHIH
Suffix:
Gender:F
Credentials:OMD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266 SMITH AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-3428
Mailing Address - Country:US
Mailing Address - Phone:845-338-6045
Mailing Address - Fax:845-338-5438
Practice Address - Street 1:266 SMITH AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-3428
Practice Address - Country:US
Practice Address - Phone:845-338-6045
Practice Address - Fax:845-338-5438
Is Sole Proprietor?:No
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001444-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist