MEDICARE: MARTIN K MELMAN MD

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
1	207R00000X	Internal Medicine Physician	126108	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1225039001	OTHER	NY	NPI

General Provider Information

NPI Number	:	1225039001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTIN K MELMAN MD

Provider Business Mailing Address
First Line	:	14 CHURCH ST
Second Line	:	SUITE 200
City	:	OSSINING
State	:	NY
Zip	:	10562-4831
Country	:	US
Telephone Number	:	914-923-9414
Fax Number	:	914-923-9412

Provider Business Practice Location Address
First Line	:	87 GRAND ST
Second Line	:
City	:	CROTON ON HUDSON
State	:	NY
Zip	:	10520-2518
Country	:	US
Telephone Number	:	914-271-4845
Fax Number	:	914-271-4839

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	04/21/2010

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