Healthcare Provider Details

I. General information

NPI: 1063328581
Provider Name (Legal Business Name): MALIK MELHADO PT,DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

887A E NEW YORK AVE
BROOKLYN NY
11203-1309
US

IV. Provider business mailing address

153 E 95TH ST
BROOKLYN NY
11212-2940
US

V. Phone/Fax

Practice location:
  • Phone: 718-221-1022
  • Fax:
Mailing address:
  • Phone: 917-373-7445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number056221
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: