Doctor Name: | MR. PETER MELENDEZ |
NPI Number: | 1740592872 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.C.S.W |
License Number: | 6731650 |
Business Practice Address: | 175 Glade Dr Long Pond, PA - 183349795 |
Business Phone Number: | 9179413491 |
Business Fax Number: | |
Mailing Address: | 175 Glade Dr, LONG POND |
State: | PA |
Postal Code: | 183349795 |
Phone Number: | 9179413491 |
Fax Number: | |
NPI Enumeration Date: | 07/06/2010 |
NPI Last Update Date: | 07/06/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6731650 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |