Melaku Antoine

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BH004708 Issued in PA

Practice address

528 Elm Ave
Upper Darby, PA 19082-2125

Phone

(267) 243-0597

NPI assigned

Apr 9, 2021

Last updated

Apr 9, 2021By the provider in NPPES

Sex

Male

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": "1617926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1811577257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 ELM AVE",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190822125",
            "telephone_number": "267-243-0597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 ELM AVE",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190822125",
            "telephone_number": "267-243-0597"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "139 Montgomery Ave",
            "address_purpose": "LOCATION",
            "city": "Bala Cynwyd",
            "state": "PA",
            "postal_code": "190042821",
            "country_code": "US",
            "telephone_number": "610-664-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTOINE",
        "first_name": "MELAKU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-09",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "BH004708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Upper Darby, PA
• Providers in Upper Darby, PA by specialty
• Behavior Analyst in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; 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.