| Philip Melnekoff, Ph.d.,pc | |
|
108 Terryville Road Port Jefferson Station NY 11776-0248 | |
| (631) 928-2349 | |
| Not Available |
| Full Name | Philip Melnekoff, Ph.d.,pc |
|---|---|
| Speciality | Psychologist |
| Location | 108 Terryville Road, Port Jefferson Station, New York |
| Authorized Official Name and Position | Philip Melnekoff (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 6319282349 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Philip Melnekoff, Ph.d.,pc 108 Terryville Road Port Jefferson Station NY 11776-0248 Ph: (631) 928-2349 | Philip Melnekoff, Ph.d.,pc 108 Terryville Road Port Jefferson Station NY 11776-0248 Ph: (631) 928-2349 |
| NPI Number | 1770853236 |
|---|---|
| Provider Enumeration Date | 12/30/2011 |
| Last Update Date | 12/30/2011 |
| Medicare PECOS PAC ID | 2163698374 |
|---|---|
| Medicare Enrollment ID | O20120110000008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770853236 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Philip Melnekoff |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013129519 PECOS PAC ID: 5890961007 Enrollment ID: I20120110000015 |
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