Provider Demographics
NPI:1770799777
Name:MELARTIN, RIIKKA LIISA (PSYD)
Entity type:Individual
Prefix:DR
First Name:RIIKKA
Middle Name:LIISA
Last Name:MELARTIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 PETERS ST
Mailing Address - Street 2:APARTMENT 2
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-4521
Mailing Address - Country:US
Mailing Address - Phone:617-970-4147
Mailing Address - Fax:
Practice Address - Street 1:321 COLUMBUS AVE
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-5168
Practice Address - Country:US
Practice Address - Phone:617-424-0765
Practice Address - Fax:617-424-0786
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7299103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW06091OtherBLUE CROSS
MAW51284Medicare ID - Type Unspecified