Active NPI
Melvin Wynne, HUMAN SERVICE
- Private Vehicle
- Brooklyn, NY
National Provider Identifier
1104105451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Private Vehicle
- License
- 197829188
- Practice address
- 970 E 100TH St
Brooklyn, NY 11236-4014 - Phone
- (347) 589-7246
- Fax
- (347) 405-8894
- NPI assigned
- Aug 4, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | 197829188 | NY | Primary |
Addresses
Primary practice location
970 E 100TH St
Brooklyn, NY 11236-4014
Mailing address
970 E 100TH St
Brooklyn, NY 11236-4014
Phone (347) 589-7246
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 197829188 | NY | MD | Private Vehicle |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312416000000",
"number": "1104105451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "970 E 100TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112364014",
"telephone_number": "347-589-7246",
"fax_number": "347-405-8894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "970 E 100TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112364014",
"telephone_number": "347-589-7246",
"fax_number": "347-405-8894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYNNE",
"first_name": "MELVIN",
"credential": "HUMAN SERVICE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-04",
"last_updated": "2011-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": "NY",
"license": "197829188",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.