Provider Demographics
NPI:1992702880
Name:MELMAN, JAY E (DPM)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:E
Last Name:MELMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 S 17TH ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-6704
Mailing Address - Country:US
Mailing Address - Phone:610-821-9585
Mailing Address - Fax:610-821-9586
Practice Address - Street 1:103 S 17TH ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-6704
Practice Address - Country:US
Practice Address - Phone:610-821-9585
Practice Address - Fax:610-821-9586
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002004L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01213601OtherCAPITAL BLUE CROSS
PA1435411OtherHIGHMARK BLUE SHIELD
GA480033042OtherRAILROAD MEDICARE
GA480033042OtherRAILROAD MEDICARE
PAT78231Medicare UPIN