Provider Demographics
NPI:1174519268
Name:BREITE, MELVIN J (MD)
Entity type:Individual
Prefix:DR
First Name:MELVIN
Middle Name:J
Last Name:BREITE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2391 BELL BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-2019
Mailing Address - Country:US
Mailing Address - Phone:718-224-2743
Mailing Address - Fax:718-224-5684
Practice Address - Street 1:2391 BELL BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-2019
Practice Address - Country:US
Practice Address - Phone:718-224-2743
Practice Address - Fax:718-224-5684
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2022-12-13
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Provider Licenses
StateLicense IDTaxonomies
NY092545207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00149353Medicaid
NY00149353Medicaid
NY44957Medicare PIN
NYG400068290Medicare PIN