MEDICARE: MS. MELANIE MARIE BYRNE BCBA

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	103K00000X	Behavior Analyst	1-19-38017	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447766316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELANIE MARIE BYRNE BCBA

Provider Business Mailing Address
First Line	:	40 CONGER ST APT 1004A
Second Line	:
City	:	BLOOMFIELD
State	:	NJ
Zip	:	07003-3334
Country	:	US
Telephone Number	:	860-471-9320
Fax Number	:

Provider Business Practice Location Address
First Line	:	2780 MORRIS AVE STE 1B
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-4848
Country	:	US
Telephone Number	:	877-971-6042
Fax Number	:

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

Provider Enumeration Date	:	12/14/2017
Last Update Date	:	05/31/2023

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