Provider Demographics
NPI:1992712236
Name:MELAMED, SCOTT ADAM (DPM)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ADAM
Last Name:MELAMED
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:250 E 40TH ST
Mailing Address - Street 2:16A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-1721
Mailing Address - Country:US
Mailing Address - Phone:347-408-8228
Mailing Address - Fax:212-228-7119
Practice Address - Street 1:303 2ND AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2739
Practice Address - Country:US
Practice Address - Phone:212-228-5230
Practice Address - Fax:212-228-7119
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006270-1213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
030000762CT01OtherBCBS
077620OtherCONNECTICARE
2859643OtherAETNA
2V1615OtherHEALTHNET
480034097OtherUHC
P2717851OtherOXFORD
030000762CT01OtherBCBS
077620OtherCONNECTICARE