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1689734055 NPI number — MELISSA LEYVA

NPI Number: 1689734055
Health Care Provider/Practitioner: MELISSA LEYVA

Information about “1689734055” NPI (MELISSA LEYVA) exists in 1689734055 in HTML format HTML  |  1689734055 in plain Text format TXT  |  1689734055 in PDF (Portable Document Format) PDF  |  1689734055 in an XML format XML  formats.

NPI Number : 1689734055 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1689734055",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LEYVA",
    "FirstName": "MELISSA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "331 NEWMAN SPRINGS ROAD",
    "SecondLineMailingAddress": "BLDG. 2, SUITE 220",
    "MailingAddressCityName": "RED BANK",
    "MailingAddressStateName": "NJ",
    "MailingAddressPostalCode": "07701",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "732-807-0877",
    "MailingAddressFaxNumber": "201-751-1680",
    "FirstLinePracticeLocationAddress": "155 POLIFLY RD STE 102",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HACKENSACK",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "07601-1771",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "551-996-8840",
    "PracticeLocationAddressFaxNumber": "201-441-9949",
    "EnumerationDate": "12/08/2006",
    "LastUpdateDate": "06/12/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "2080P0206X",
        "TaxonomyName": "Pediatric Gastroenterology Physician",
        "LicenseNumber": "25MA08013700",
        "LicenseNumberStateCode": "NJ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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