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General NPI Number Information
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NPI Number | 1548849458
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Entity Type | Individual
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Provider Name | MELANIE ADITTYA
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Gender | Female
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Dates
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Enumeration Date | 04/07/2021
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Last Update Date | 07/26/2024
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Provider Practice Location Address
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Address Line | 345 N MAIN ST STE 260
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City | WEST HARTFORD
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State | CT
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Zip | 06117-2508
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Country | US
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Telephone | 203-816-0091
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Fax |
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Provider Business Mailing Address
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Address Line | 61 STAFFORD AVE
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City | NEWINGTON
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State | CT
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Zip | 06111-3434
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Country | US
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Telephone | 978-875-4037
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 007661
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License Number State | CT
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