Active NPI
Dara Melnick
- Early Intervention Provider Agency
- Smithtown, NY
National Provider Identifier
1265742498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Early Intervention Provider Agency
- License
- 004460
- Practice address
- 11 Route 111
Smithtown, NY 11787-3712 - Phone
- (516) 528-3000
- NPI assigned
- Oct 21, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Early Intervention Provider Agency | 252Y00000X | 004460 | NY | Primary |
Addresses
Primary practice location
11 Route 111
Smithtown, NY 11787-3712
Mailing address
11 Route 111
Smithtown, NY 11787-3712
Phone (516) 528-3000
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 |
|---|---|---|---|
| 004460 | NY | MD | Early Intervention Provider Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287619200000",
"number": "1265742498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 ROUTE 111",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117873712",
"telephone_number": "516-528-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 ROUTE 111",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117873712",
"telephone_number": "516-528-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELNICK",
"first_name": "DARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-21",
"last_updated": "2010-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "252Y00000X",
"taxonomy_group": "",
"desc": "Early Intervention Provider Agency",
"state": "NY",
"license": "004460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smithtown, NY
- Desiree Meier-Frost, MHC
- Maritza Mejia, NURSE PRACTITIONER
- Melanie Murphy Acupuncture P.C.
- Melanie Perlson
- Scarlet Yvonne Melendez, R.N.
- Mary L Mendes, LCSW, CEAP
- Michael Anthony Mennella, M.D.
- Mens Health of Smithtown
- Mental Health Nurse Practitioner Consultation Services PC
- Stephanie Jeanne Menzer, MA CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.