Provider Demographics
NPI:1871067074
Name:MELECH MANN LLC
Entity type:Organization
Organization Name:MELECH MANN LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER OF MELECH MANN LLC
Authorized Official - Prefix:MR
Authorized Official - First Name:MELECH
Authorized Official - Middle Name:D
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:LISW MSW EMDR
Authorized Official - Phone:929-278-0537
Mailing Address - Street 1:1032 BAY 24TH ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-1802
Mailing Address - Country:US
Mailing Address - Phone:929-278-0537
Mailing Address - Fax:
Practice Address - Street 1:1032 BAY 24TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-1802
Practice Address - Country:US
Practice Address - Phone:929-278-0537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-22
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZI1000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherIllustration, MedicalGroup - Single Specialty