Provider Demographics
NPI:1275011090
Name:MELNICK, SYDNEY (MPS, ATR-BC, LPAT)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:MELNICK
Suffix:
Gender:F
Credentials:MPS, ATR-BC, LPAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 HIGHWAY 22 STE 7
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809-1376
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:44 HIGHWAY 22 STE 7
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809-1376
Practice Address - Country:US
Practice Address - Phone:908-463-4002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
NJ16LP00027000221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician