Healthcare Provider Details

I. General information

NPI: 1699444224
Provider Name (Legal Business Name): MELANIE SANTOS ZAVALA WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2021
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 MILLBURN AVE
MILLBURN NJ
07041-1739
US

IV. Provider business mailing address

46 2ND AVE
GARWOOD NJ
07027-1125
US

V. Phone/Fax

Practice location:
  • Phone: 862-289-6590
  • Fax:
Mailing address:
  • Phone: 908-967-4809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number421505
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number26NJ01459600
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number26NJ01459600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: