Healthcare Provider Details

I. General information

NPI: 1205535234
Provider Name (Legal Business Name): MELISSA ANN MAY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2023
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 VALLEY RD # 148
MONTCLAIR NJ
07042-2709
US

IV. Provider business mailing address

1 LETHBRIDGE PLZ STE 20
MAHWAH NJ
07430-2114
US

V. Phone/Fax

Practice location:
  • Phone: 973-559-4600
  • Fax: 855-998-4358
Mailing address:
  • Phone: 609-474-0120
  • Fax: 609-474-0121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP032502
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number26NJ01448300
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ01448300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: