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General NPI Number Information
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NPI Number | 1447504055
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Entity Type | Individual
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Provider Name | MRS. MELISSA DECAPUA
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Gender | Female
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Dates
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Enumeration Date | 11/05/2012
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Last Update Date | 05/30/2013
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Provider Practice Location Address
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Address Line | 2100 MACK BLVD 2ND FLOOR
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City | ALLENTOWN
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State | PA
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Zip | 18103-5622
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Country | US
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Telephone | 484-884-4500
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Fax | 484-884-0699
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Provider Business Mailing Address
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Address Line | 1251 S CEDAR CREST BLVD STE 202A
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City | ALLENTOWN
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State | PA
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Zip | 18103-6205
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Country | US
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Telephone | 610-402-5766
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Fax | 610-402-5763
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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 | SP012488
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License Number State | PA
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