MEDICARE: VIKTORIA MELNYK

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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1528736618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIKTORIA MELNYK

Provider Business Mailing Address
First Line	:	2011 OCEAN AVE APT 3K
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-6812
Country	:	US
Telephone Number	:	718-208-9254
Fax Number	:

Provider Business Practice Location Address
First Line	:	2571 E 17TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-3515
Country	:	US
Telephone Number	:	929-371-2131
Fax Number	:

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

Provider Enumeration Date	:	09/02/2021
Last Update Date	:	09/02/2021

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