Healthcare Provider Details

I. General information

NPI: 1194948802
Provider Name (Legal Business Name): MELINDA A. PARISI PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 WITHERSPOON ST
PRINCETON NJ
08540-3211
US

IV. Provider business mailing address

262 HICKORY RD
YARDLEY PA
19067-3409
US

V. Phone/Fax

Practice location:
  • Phone: 609-497-4000
  • Fax: 609-497-4412
Mailing address:
  • Phone: 215-206-2180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number35SI00385100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: