Healthcare Provider Details

I. General information

NPI: 1790298800
Provider Name (Legal Business Name): MELINA MEJIA LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2017
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E 233RD ST
BRONX NY
10466-2604
US

IV. Provider business mailing address

600 E 233RD ST
BRONX NY
10466-2604
US

V. Phone/Fax

Practice location:
  • Phone: 718-920-9000
  • Fax:
Mailing address:
  • Phone: 718-920-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1015141
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: