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General NPI Number Information
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NPI Number | 1548487994
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Entity Type | Individual
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Provider Name | MELISSA FULENO JOHNSON MPT
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 03/18/2021
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Provider Practice Location Address
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Address Line | 1211 WILMINGTON AVE
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City | NEW CASTLE
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State | PA
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Zip | 16105-2516
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Country | US
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Telephone | 724-656-4056
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Fax |
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Provider Business Mailing Address
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Address Line | 127 NESHANNOCK TRAILS DR
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City | NEW CASTLE
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State | PA
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Zip | 16105-2907
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Country | US
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Telephone | 724-658-5060
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT008887-L
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License Number State | PA
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