Healthcare Provider Details

I. General information

NPI: 1164467999
Provider Name (Legal Business Name): RICHARD A. MELEO D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 CEDAR ST
NORTH PLAINFIELD NJ
07060-3908
US

IV. Provider business mailing address

176 CEDAR ST
NORTH PLAINFIELD NJ
07060-3908
US

V. Phone/Fax

Practice location:
  • Phone: 908-757-2613
  • Fax:
Mailing address:
  • Phone: 908-757-2613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDI 11761
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: