Provider Demographics
NPI:1114693777
Name:VARDA, MELISSA JOI (MSN, RN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:JOI
Last Name:VARDA
Suffix:
Gender:F
Credentials:MSN, RN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1180 6TH AVE FL 8
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-8401
Mailing Address - Country:US
Mailing Address - Phone:917-923-0569
Mailing Address - Fax:
Practice Address - Street 1:1180 6TH AVE FL 8
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-8401
Practice Address - Country:US
Practice Address - Phone:917-923-0569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY403674363LP0808X
NY627084163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health