Provider Demographics
NPI:1619117744
Name:MELAMED, LEAH JEANNE (MS,CCC/SLP)
Entity type:Individual
Prefix:MS
First Name:LEAH
Middle Name:JEANNE
Last Name:MELAMED
Suffix:
Gender:F
Credentials:MS,CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 KATHAY DR
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4711
Mailing Address - Country:US
Mailing Address - Phone:973-220-9225
Mailing Address - Fax:
Practice Address - Street 1:11 KATHAY DR
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4711
Practice Address - Country:US
Practice Address - Phone:973-220-9225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY06995-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist