Provider Demographics
NPI:1205981545
Name:MELODY S. BEHNAM, MD, PC
Entity type:Organization
Organization Name:MELODY S. BEHNAM, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:JANETE
Authorized Official - Middle Name:C
Authorized Official - Last Name:TEIXEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-447-1620
Mailing Address - Street 1:309 IROQUOIS LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-1047
Mailing Address - Country:US
Mailing Address - Phone:201-447-1620
Mailing Address - Fax:
Practice Address - Street 1:317 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3316
Practice Address - Country:US
Practice Address - Phone:201-447-1620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ094124Medicare ID - Type Unspecified
NJI39880Medicare UPIN