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NPI Code Detail

MEDICARE: DR. MELISSA PEARL KINER PSY.D.

MEDICARE: DR. MELISSA PEARL KINER PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TS0200XSchool PsychologistP77142NY
2103T00000XPsychologist025228-01NY

General Provider Information

NPI Number : 1194031674
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MELISSA PEARL KINER PSY.D.
Provider Business Mailing Address
First Line : 450 FRANK ST
Second Line :
City : OCEANSIDE
State : NY
Zip : 11572-2813
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 535 S OYSTER BAY RD
Second Line :
City : PLAINVIEW
State : NY
Zip : 11803-3310
Country : US
Telephone Number : 516-888-4357
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2010
Last Update Date : 10/24/2023

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