Provider Demographics
NPI:1942084470
Name:MELENDEZ, PERLA S (BEHAVIOR TECH)
Entity Type:Individual
Prefix:
First Name:PERLA
Middle Name:S
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:BEHAVIOR TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 W 145TH ST APT 3B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-5438
Mailing Address - Country:US
Mailing Address - Phone:929-396-8651
Mailing Address - Fax:
Practice Address - Street 1:520 W 145TH ST APT 3B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-5438
Practice Address - Country:US
Practice Address - Phone:929-396-8651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician