MEDICARE: MELINA FENEQUE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	P86110	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316281405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELINA FENEQUE

Provider Business Mailing Address
First Line	:	520 W 135TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10031-8601
Country	:	US
Telephone Number	:	212-694-9200
Fax Number	:

Provider Business Practice Location Address
First Line	:	520 W 135TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10031-8601
Country	:	US
Telephone Number	:	212-694-9200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2012
Last Update Date	:	06/03/2026

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Directions to “ MELINA FENEQUE ” Practice Location

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