Provider Demographics
NPI:1316089832
Name:MELGAR, VERONICA (MS SPECIAL EDUCATION)
Entity type:Individual
Prefix:MS
First Name:VERONICA
Middle Name:
Last Name:MELGAR
Suffix:
Gender:F
Credentials:MS SPECIAL EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 CORLETT PL
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-1032
Mailing Address - Country:US
Mailing Address - Phone:631-423-3053
Mailing Address - Fax:
Practice Address - Street 1:37 CORLETT PL
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-1032
Practice Address - Country:US
Practice Address - Phone:631-423-3053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251C00000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No251C00000XAgenciesDay Training, Developmentally Disabled Services