Healthcare Provider Details

I. General information

NPI: 1780910281
Provider Name (Legal Business Name): MS. MELANIE ANDREA COLON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2009
Last Update Date: 10/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50-98 EAST 168TH STREET
BRONX NY
10452-3525
US

IV. Provider business mailing address

1941 3RD AVE APT 12F
NEW YORK NY
10029-4048
US

V. Phone/Fax

Practice location:
  • Phone: 718-293-3900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: