Organization
MELAND-LEWIS PSYCHOLOGICAL SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLI ANN MELAND-LEWIS PHD (SOLE MEMBER)
(845) 978-2758
Entity
Organization
Contact information
Practice address
22 NORTH RD, BLOOMINGBURG, NY 12721-4687
(845) 978-2758
Mailing address
32 SCHREMPP LN, PINE BUSH, NY 12566-5735
(845) 978-2758
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
017814
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03133575
—
NY
01
—
A300000977
MEDICARE PROVIDER NUMBER
NY
Enumeration date
08/30/2013
Last updated
08/30/2013
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