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General NPI Number Information
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NPI Number | 1215090600
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Entity Type | Organization
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Legal Business Name | GREER G. MELIDONIS PSY.D. LLC
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 01/23/2009
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Provider Practice Location Address
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Address Line | 105 OMNI DR CENTER FOR COLLABORATIVE PSYCHOLOGY, PA
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City | HILLSBOROUGH
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State | NJ
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Zip | 08844-4512
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Country | US
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Telephone | 908-359-2466
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Fax | 908-359-0746
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Provider Business Mailing Address
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Address Line | 105 OMNI DR CENTER FOR COLLABORATIVE PSYCHOLOGY, PA
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City | HILLSBOROUGH
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State | NJ
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Zip | 08844-4512
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Country | US
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Telephone | 908-359-2466
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Fax | 908-359-0746
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Authorized Official
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Title or Position | MEMBER/MANAGER
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Name | DR. GREER GRIERSON MELIDONIS
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Credential | PSY.D.
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Telephone | 908-359-2466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | SI03317
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License Number State | NJ
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