Healthcare Provider Details

I. General information

NPI: 1649455593
Provider Name (Legal Business Name): MELISSA ANNE MARTEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2008
Last Update Date: 01/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CAMBRIDGE DR
NEWARK DE
19711-2792
US

IV. Provider business mailing address

700 CAMBRIDGE DR
NEWARK DE
19711-2792
US

V. Phone/Fax

Practice location:
  • Phone: 610-660-0742
  • Fax:
Mailing address:
  • Phone: 610-660-0742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: