Provider Demographics
NPI:1871511725
Name:WELBY, MELISSA K (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:K
Last Name:WELBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:WHEELOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:99 CHERRY ST
Mailing Address - Street 2:UNIT D
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3455
Mailing Address - Country:US
Mailing Address - Phone:203-906-6294
Mailing Address - Fax:203-283-7857
Practice Address - Street 1:99 CHERRY ST
Practice Address - Street 2:UNIT D
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3455
Practice Address - Country:US
Practice Address - Phone:203-906-6294
Practice Address - Fax:203-283-7857
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0417152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTH69154Medicare UPIN
CT260004118Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CT004039244Medicaid