Melinda E Delazar, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

019455-1 Issued in NY

Practice address

410 Gidney Ave Stop 3
Newburgh, NY 12550-3764

Phone

(845) 243-0190

Fax

(845) 565-5374

NPI assigned

Jan 24, 2012

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 identifiers 1

Other names 1

• Dr. Melinda E Park Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1327363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1508137472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MID-HUDSON FORENSIC PSYCHIATRIC CENTER",
            "address_2": "2834 ROUTE 17-M",
            "city": "NEW HAMPTON",
            "state": "NY",
            "postal_code": "10958",
            "telephone_number": "845-374-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 GIDNEY AVE STOP 3",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125503764",
            "telephone_number": "845-243-0190",
            "fax_number": "845-565-5374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELAZAR",
        "first_name": "MELINDA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-24",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "019455-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03498006",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELINDA",
            "last_name": "PARK",
            "middle_name": "E",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Luz D Dejesus
• Jessica Marie Del Gaudio, LMHC
• Vito M Del Grosso
• Kevin Andrew Del Regno, PA-C
• Sofia Delarosa
• Michele Romano Dell'Aquila, RN BSN
• Debora Elaine Deluise, RPH
• Anna Dzierzyk Demirer, MS ED.
• Irene M Denaro, BA
• Dominick John Denisi, DC

• Clinical Psychologist in Newburgh, NY
• Providers in Newburgh, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.