Healthcare Provider Details

I. General information

NPI: 1760464929
Provider Name (Legal Business Name): MELISSA HERR RUBIN MA
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: MELISSA ANN HERR MA

II. Dates (important events)

Enumeration Date: 11/15/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 WHITE HORSE PIKE SUITE 7
BARRINGTON NJ
08007-1322
US

IV. Provider business mailing address

746 FITZWATER ST
PHILADELPHIA PA
19147-2815
US

V. Phone/Fax

Practice location:
  • Phone: 856-546-1535
  • Fax: 856-546-6565
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number41YA00058100
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number25MG00091400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: