Individual provider Active NPI

Lariska Melenciano

  • Specialist
  • Nanuet, NY
National Provider Identifier
1831934041
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
2887194 Issued in NY
Practice address
6 Forest Brook Rd
Nanuet, NY 10954-4425
Phone
(646) 546-6281
NPI assigned
Jun 28, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2887194 NY Primary

Addresses

Primary practice location

6 Forest Brook Rd
Nanuet, NY 10954-4425

Mailing address

6 Forest Brook Rd
Nanuet, NY 10954-4425
Phone (646) 546-6281

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
2887194NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1831934041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 FOREST BROOK RD",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109544425",
            "telephone_number": "646-546-6281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 FOREST BROOK RD",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109544425",
            "telephone_number": "646-546-6281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELENCIANO",
        "first_name": "LARISKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "2887194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nanuet, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.