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General NPI Number Information
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NPI Number | 1063355451
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Entity Type | Individual
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Provider Name | MELLANIE JABLON
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Gender | Female
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Dates
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Enumeration Date | 04/11/2026
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Last Update Date | 04/13/2026
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Provider Practice Location Address
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Address Line | 607 NORTH AVE # 18
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City | WAKEFIELD
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State | MA
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Zip | 01880-1322
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Country | US
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Telephone | 781-705-0567
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Fax |
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Provider Business Mailing Address
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Address Line | 4073 NW 7TH PL
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City | DEERFIELD BCH
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State | FL
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Zip | 33442-7321
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN10042622
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License Number State | MA
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