1598105678 NPI number — MRS. MELANIE ANN ZEMAN LCSW

Table of content: MRS. MELANIE ANN ZEMAN LCSW (NPI 1598105678)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598105678 NPI number — MRS. MELANIE ANN ZEMAN LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZEMAN
Provider First Name:
MELANIE
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598105678
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/13/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
579 HAMILTON PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RIVERVALE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07675-5609
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
551-804-6875
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
210 SUMMIT AVE
Provider Second Line Business Practice Location Address:
STE A9
Provider Business Practice Location Address City Name:
MONTVALE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07645-1526
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-781-2901
Provider Business Practice Location Address Fax Number:
855-254-4181
Provider Enumeration Date:
07/03/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  080791-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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