Individual
MELISSA ANN MELKUMOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
19 WEST 34TH ST, PENTHOUSE, NEW YORK, NY 10001
(646) 374-8840
Mailing address
491 6TH AVE APT 3, BROOKLYN, NY 11215-4041
(734) 276-5021
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
022561
NY
103TC0700X
Clinical Psychologist
Primary
022561
NY
Other
Enumeration date
02/09/2018
Last updated
02/09/2018
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