Provider Demographics
NPI:1528314762
Name:MELAMED, EITAN (MD)
Entity type:Individual
Prefix:
First Name:EITAN
Middle Name:
Last Name:MELAMED
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 1:353 E 17TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3821
Mailing Address - Country:US
Mailing Address - Phone:212-420-3743
Mailing Address - Fax:212-340-0038
Practice Address - Street 1:321 E 34TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4942
Practice Address - Country:US
Practice Address - Phone:212-340-0000
Practice Address - Fax:212-340-0038
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-25
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY271186207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery