Individual provider Active NPI

Melanie Eichelbaum Wilken, M.S.ED

  • Specialist
  • Oceanside, NY
National Provider Identifier
1780934828
Registry record updated Sep 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1249557 Issued in NY
Practice address
3726 Carrel Blvd
Oceanside, NY 11572-5916
Phone
(646) 621-7444
NPI assigned
Sep 17, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1249557 NY Primary

Addresses

Primary practice location

3726 Carrel Blvd
Oceanside, NY 11572-5916

Mailing address

3726 Carrel Blvd
Oceanside, NY 11572-5916
Phone (646) 621-7444

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
1249557NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347840000000",
    "number": "1780934828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3726 CARREL BLVD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115725916",
            "telephone_number": "646-621-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3726 CARREL BLVD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115725916",
            "telephone_number": "646-621-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKEN",
        "first_name": "MELANIE",
        "middle_name": "EICHELBAUM",
        "name_prefix": "Mrs.",
        "credential": "M.S.ED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-17",
        "last_updated": "2012-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1249557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; 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.