Individual provider Active NPI

Melissa Chan

  • Early Intervention Provider Agency
  • Long Island City, NY
National Provider Identifier
1265397939
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Practice address
5627 2ND St Apt 1608
Long Island City, NY 11101-6411
Phone
(347) 536-8567
NPI assigned
Dec 16, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X NY Primary

Addresses

Primary practice location

5627 2ND St Apt 1608
Long Island City, NY 11101-6411

Mailing address

5627 2ND St Apt 1608
Long Island City, NY 11101-6411
Phone (347) 536-8567

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1765843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1265397939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5627 2ND ST APT 1608",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111016411",
            "telephone_number": "347-536-8567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5627 2ND ST APT 1608",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111016411",
            "telephone_number": "347-536-8567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "MELISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-16",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.