Provider Demographics
NPI:1235932153
Name:MELEKA, MARIAN
Entity type:Individual
Prefix:
First Name:MARIAN
Middle Name:
Last Name:MELEKA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-2228
Mailing Address - Country:US
Mailing Address - Phone:718-386-4111
Mailing Address - Fax:
Practice Address - Street 1:606 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-2228
Practice Address - Country:US
Practice Address - Phone:718-386-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-27
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071651183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist