Provider Demographics
NPI:1780769463
Name:MELTON, R. CHRISTINE (MD)
Entity type:Individual
Prefix:DR
First Name:R. CHRISTINE
Middle Name:
Last Name:MELTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:247 3RD AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-7457
Mailing Address - Country:US
Mailing Address - Phone:212-475-3791
Mailing Address - Fax:212-475-5228
Practice Address - Street 1:247 3RD AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-7457
Practice Address - Country:US
Practice Address - Phone:212-475-3791
Practice Address - Fax:212-475-5228
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY141544207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY50A011OtherBLUE CROSS
NY00641465Medicaid
NY0073287OtherGHI
NYNS4115OtherOXFORD
NY0073287OtherGHI