Healthcare Provider Details

I. General information

NPI: 1588898167
Provider Name (Legal Business Name): FEBIN MELEPURA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2009
Last Update Date: 03/20/2024
Certification Date: 03/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 W 44TH ST STE 914
NEW YORK NY
10036-8104
US

IV. Provider business mailing address

36 W 44TH ST STE 1416
NEW YORK NY
10036-8104
US

V. Phone/Fax

Practice location:
  • Phone: 212-621-7746
  • Fax:
Mailing address:
  • Phone: 212-621-7746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number271559
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: