Individual provider Active NPI

Tatiana Melnikov

  • Early Intervention Provider Agency
  • Brooklyn, NY
National Provider Identifier
1710753009
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
1199439 Issued in NY
Practice address
1565 E 14TH St Apt 6G
Brooklyn, NY 11230-7156
Phone
(718) 708-9315
NPI assigned
Nov 28, 2023
Last updated
Nov 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 1199439 NY
Early Intervention Provider Agency 252Y00000X 1199439 NY Primary

Addresses

Primary practice location

1565 E 14TH St Apt 6G
Brooklyn, NY 11230-7156

Mailing address

1565 E 14TH St Apt 6G
Brooklyn, NY 11230-7156
Phone (718) 708-9315

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

LicenseStateTypeSpecialty
1199439NYMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1710753009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 E 14TH ST APT 6G",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112307156",
            "telephone_number": "718-708-9315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 E 14TH ST APT 6G",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112307156",
            "telephone_number": "718-708-9315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELNIKOV",
        "first_name": "TATIANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-28",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "1199439",
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "1199439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.