Provider Demographics
NPI:1821239732
Name:MELINKOV, YAKOV D (LAC)
Entity Type:Individual
Prefix:MR
First Name:YAKOV
Middle Name:D
Last Name:MELINKOV
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 KNAPPS HWY
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-4341
Mailing Address - Country:US
Mailing Address - Phone:203-368-1611
Mailing Address - Fax:
Practice Address - Street 1:999 SILVER LN
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-5343
Practice Address - Country:US
Practice Address - Phone:203-380-5274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000127171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist