Healthcare Provider Details

I. General information

NPI: 1225039001
Provider Name (Legal Business Name): MARTIN K MELMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 04/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87 GRAND ST
CROTON ON HUDSON NY
10520-2518
US

IV. Provider business mailing address

14 CHURCH ST SUITE 200
OSSINING NY
10562-4831
US

V. Phone/Fax

Practice location:
  • Phone: 914-271-4845
  • Fax: 914-271-4839
Mailing address:
  • Phone: 914-923-9414
  • Fax: 914-923-9412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number126108
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: