Healthcare Provider Details

I. General information

NPI: 1871977298
Provider Name (Legal Business Name): SIARHEI MELNIKAU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: SIARHEI MELNIKAU MD

II. Dates (important events)

Enumeration Date: 07/15/2015
Last Update Date: 11/07/2021
Certification Date: 11/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 86TH ST APT 2D
BROOKLYN NY
11209-5027
US

IV. Provider business mailing address

321 86TH ST APT 2D
BROOKLYN NY
11209-5027
US

V. Phone/Fax

Practice location:
  • Phone: 646-924-9367
  • Fax:
Mailing address:
  • Phone: 646-924-9367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number313381
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: