Healthcare Provider Details

I. General information

NPI: 1689124042
Provider Name (Legal Business Name): MELISSA C SCHWEDHELM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2016
Last Update Date: 04/25/2023
Certification Date: 04/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 WASHINGTON STREET NEONATOLOGY
HARTFORD CT
06106-0610
US

IV. Provider business mailing address

66 LINCOLN ST
SLOATSBURG NY
10974-1216
US

V. Phone/Fax

Practice location:
  • Phone: 347-867-5747
  • Fax:
Mailing address:
  • Phone: 347-867-5747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number68085
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number19006
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number68085
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: