Provider Demographics
NPI:1770828063
Name:BOYKIN, MELINDA E
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:E
Last Name:BOYKIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 DREXEL AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-1313
Mailing Address - Country:US
Mailing Address - Phone:610-348-7581
Mailing Address - Fax:
Practice Address - Street 1:203 DREXEL AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:LANSDOWNE
Practice Address - State:PA
Practice Address - Zip Code:19050-1313
Practice Address - Country:US
Practice Address - Phone:610-348-7581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-28
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist