Dr. Philip Melnekoff
Clinical Psychologist
108 Terryville Road
Port Jefferson Station
, New York 11776-0248
Dr. Philip Melnekoff
Clinical Psychologist
108 Terryville Road
Port Jefferson Station
, New York 11776-0248
(631) 473-7830
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About
Features
Specialties
- Clinical Psychologist
Languages spoken
- English
Location
First Address
- Dr. Philip Melnekoff
- 108 Terryville Rd
- Port Jefferson Station, NY
- Zip : 11776-1329
- Fax : (631) 473-7830
- Phone :
Second Address
- Dr. Philip Melnekoff
- 108 Terryville Road
- Port Jefferson Station, NY
- Zip : 11776-0248
- Fax : (631) 473-7830
- Phone : (631) 928-2349
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103G00000X | Clinical Psychologist | 004072 | NY |
| Y | 103TC0700X | Clinical Psychologist | 004072 | NY |
National Provider Identifier
| NPI | 1013129519 |
|---|---|
| Provider Name | Dr. Philip Melnekoff |
| First Address | Port Jefferson Station, NY 11776-1329 |
| Second Address | Port Jefferson Station, NY 11776-0248 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/05/2007 |
| Last Update Date | 24/03/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0052416 | GHI (01) | NY |
| 144384 | VALUEOPTIONS (01) | NY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.