Provider Demographics
NPI:1649320128
Name:MELOUL, ELENA LEMBERG (ND, MD)
Entity type:Individual
Prefix:DR
First Name:ELENA
Middle Name:LEMBERG
Last Name:MELOUL
Suffix:
Gender:F
Credentials:ND, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1962 E CARSON DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7444
Mailing Address - Country:US
Mailing Address - Phone:480-985-6001
Mailing Address - Fax:
Practice Address - Street 1:1962 E CARSON DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7444
Practice Address - Country:US
Practice Address - Phone:480-985-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175F00000X
AZ07-657534-G171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered175F00000XOther Service ProvidersNaturopath
Not Answered171100000XOther Service ProvidersAcupuncturist