Provider Demographics
NPI:1184734493
Name:MELAMED, YAIR DROR (MD)
Entity type:Individual
Prefix:DR
First Name:YAIR
Middle Name:DROR
Last Name:MELAMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 COLISEUM AVE
Mailing Address - Street 2:SUITE 306-307
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-3206
Mailing Address - Country:US
Mailing Address - Phone:603-577-9090
Mailing Address - Fax:603-577-8976
Practice Address - Street 1:5 COLISEUM AVE
Practice Address - Street 2:SUITE 306-307
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-3206
Practice Address - Country:US
Practice Address - Phone:603-577-9090
Practice Address - Fax:603-577-8976
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10367207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30011504Medicaid
110150308OtherMEDICARE RAILROAD
MAJ14467Medicare PIN
NHRE4920Medicare PIN
MA0189316Medicare PIN
110150308OtherMEDICARE RAILROAD