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General NPI Number Information
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NPI Number | 1861538332
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Entity Type | Individual
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Provider Name | MELISSA KRESCH PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | INTERFAITH MEDICAL CENTER - DEPARTMENT OF PSYCHIATRY 1545 ATLANTIC AVENUE
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City | BROOKLYN
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State | NY
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Zip | 11213
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Country | US
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Telephone | 212-613-4921
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Fax | 212-613-4975
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Provider Business Mailing Address
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Address Line | 380 W 12TH ST #1B
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City | NEW YORK
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State | NY
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Zip | 10014-7200
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Country | US
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Telephone | 212-633-7107
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 016299
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License Number State | NY
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