Provider Demographics
NPI:1316518970
Name:MELVIN, NAKIYAH CHANELLE (BS, ATS)
Entity type:Individual
Prefix:
First Name:NAKIYAH
Middle Name:CHANELLE
Last Name:MELVIN
Suffix:
Gender:F
Credentials:BS, ATS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 SHONNARD PL
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-2293
Mailing Address - Country:US
Mailing Address - Phone:914-623-7645
Mailing Address - Fax:
Practice Address - Street 1:135 SHONNARD PL
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703-2293
Practice Address - Country:US
Practice Address - Phone:914-623-7645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program