MEDICARE: MELAINA KHUDARI

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	225100000X	Physical Therapist	PTL.0020456	CO

General Provider Information

NPI Number	:	1497552616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELAINA KHUDARI

Provider Business Mailing Address
First Line	:	1357 N WILLIAMS ST APT 311
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80218-2639
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3501 HIGHLAND PL
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80031-3359
Country	:	US
Telephone Number	:	303-951-8350
Fax Number	:

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

Provider Enumeration Date	:	02/26/2025
Last Update Date	:	02/26/2025

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Directions to “ MELAINA KHUDARI ” Practice Location

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