Provider Demographics
NPI:1699746602
Name:SCHMELKIN, IRA J (MD)
Entity type:Individual
Prefix:DR
First Name:IRA
Middle Name:J
Last Name:SCHMELKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 W SILVER ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-3628
Mailing Address - Country:US
Mailing Address - Phone:413-562-4456
Mailing Address - Fax:413-568-4211
Practice Address - Street 1:115 W SILVER ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-3628
Practice Address - Country:US
Practice Address - Phone:413-562-4456
Practice Address - Fax:413-568-4211
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA56902207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA3767901Medicare PIN
NYA400047659Medicare UPIN