Provider Demographics
NPI:1952846735
Name:MARTIN, MELISSA ROSE (JD)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ROSE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 E 62ND ST
Mailing Address - Street 2:KAREN HORNEY CLINIC
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7788
Mailing Address - Country:US
Mailing Address - Phone:212-838-4333
Mailing Address - Fax:
Practice Address - Street 1:329 E 62ND ST
Practice Address - Street 2:KAREN HORNEY CLINIC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7788
Practice Address - Country:US
Practice Address - Phone:212-838-4333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-03
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program