Melissa Noel Wildes, MASTERS OF SCIENCE

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

019872-1 Issued in NY

Practice address

1069 80TH St
Brooklyn, NY 11228-2619

Phone

(646) 533-5733

NPI assigned

Jun 8, 2010

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275955200000",
    "number": "1710207154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1069 80TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112282619",
            "telephone_number": "646-533-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1069 80TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112282619",
            "telephone_number": "646-533-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDES",
        "first_name": "MELISSA",
        "middle_name": "NOEL",
        "name_prefix": "Miss",
        "credential": "MASTERS OF SCIENCE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-08",
        "last_updated": "2010-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "019872-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avigail Wilder
• Jashonda D Wilder, LPN
• John Nicholas Wilder, MD
• Leslie Ann Wilder, P.T.
• Shawna Wilder
• Olga Wildfeuer, MD
• Winsome Wildman, NP
• Camille Wildy
• Daniel W Wilen, MD
• Jennifer Marie Wilen, CNM

• Speech-Language Pathologist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.

Verify at the official NPI Registry.