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General NPI Number Information
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NPI Number | 1063746352
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Entity Type | Individual
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Provider Name | MELISSA SARAH STARR PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 09/20/2009
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Last Update Date | 09/20/2009
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Provider Practice Location Address
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Address Line | 45 GLENVILLE RD
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City | GREENWICH
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State | CT
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Zip | 06831-5331
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Country | US
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Telephone | 203-622-9111
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Fax |
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Provider Business Mailing Address
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Address Line | 605 FOREST DR
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City | RIVERVALE
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State | NJ
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Zip | 07675-5932
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Country | US
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Telephone | 201-497-5594
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 002653
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 015249
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License Number State | NY
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