| Organization Name: | SIMON MELNICK DO, LTD |
| NPI Number: | 1316181316 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SIMON MELNICK (OWNER) |
| Mailing Address: | 1050 Main St Unit 8 East Greenwich |
| State: | RI US |
| Postal Code: | 028183162 |
| Phone Number: | 4018867030 |
| Fax Number: | 4018867031 |
| NPI Enumeration Date: | 04/22/2009 |
| NPI Last Update Date: | 04/07/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | DO00518 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | RI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |