Healthcare Provider Details

I. General information

NPI: 1003974692
Provider Name (Legal Business Name): MELVIN P MELNICK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 05/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 MARSHALL AVE.
PITTSBURGH PA
15214
US

IV. Provider business mailing address

300 S HOMEWOOD AVE
PITTSBURGH PA
15208-2714
US

V. Phone/Fax

Practice location:
  • Phone: 412-442-2885
  • Fax: 412-322-5405
Mailing address:
  • Phone: 412-442-2885
  • Fax: 412-322-5405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD014633E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD014633E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: