Provider Demographics
NPI:1922188432
Name:MELIN, ALBERT L (DC)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:L
Last Name:MELIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 GLENEIDA AVE
Mailing Address - Street 2:STE A
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-1222
Mailing Address - Country:US
Mailing Address - Phone:845-228-7000
Mailing Address - Fax:845-228-5485
Practice Address - Street 1:91 GLENEIDA AVE
Practice Address - Street 2:STE A
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-1222
Practice Address - Country:US
Practice Address - Phone:845-228-7000
Practice Address - Fax:845-228-5485
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0086511111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
X92391Medicare ID - Type Unspecified
U66716Medicare UPIN