Melanie Kuklis, N/A

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

61 Paquatuck Ave
East Moriches, NY 11940-1205

Phone

(631) 747-1737

NPI assigned

Dec 15, 2019

Last updated

Dec 15, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• N/a N/a Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1576368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576368000000",
    "number": "1366080863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 PAQUATUCK AVE",
            "city": "EAST MORICHES",
            "state": "NY",
            "postal_code": "119401205",
            "telephone_number": "631-747-1737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 PAQUATUCK AVE",
            "city": "EAST MORICHES",
            "state": "NY",
            "postal_code": "119401205",
            "telephone_number": "631-747-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUKLIS",
        "first_name": "MELANIE",
        "name_prefix": "Miss",
        "credential": "N/A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-15",
        "last_updated": "2019-12-15",
        "certification_date": "2019-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "N/A",
            "last_name": "N/A",
            "credential": "MELANIE GEOGHAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Eileen Kelly, M.D.
• Rebecca A Kincade, IDHS
• Jennifer Lynn Klingenberger-Beyer, M.D.
• Lisa Kominos
• Stacy Ann Krey, LMT
• Carly Lawrence
• Irene Logan, NURSE PRACTITIONER
• Diana Lucenti
• Kristina Macdonald, CRC
• Erica Lee Mailand, MA

• Behavior Technician in East Moriches, NY
• Providers in East Moriches, NY by specialty
• Behavior Technician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2019; 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.