Provider Demographics
NPI:1669621728
Name:MELMAN, HARRIET (MC CRC)
Entity type:Individual
Prefix:MS
First Name:HARRIET
Middle Name:
Last Name:MELMAN
Suffix:
Gender:F
Credentials:MC CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 N CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14604-1404
Mailing Address - Country:US
Mailing Address - Phone:585-232-1840
Mailing Address - Fax:585-232-8419
Practice Address - Street 1:30 N CLINTON AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14604-1404
Practice Address - Country:US
Practice Address - Phone:585-232-1840
Practice Address - Fax:585-232-8419
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CRCC 00009329225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner