MEDICARE: DR. MELANIE-ANN LLANES PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	40QA01911200	NJ

General Provider Information

NPI Number	:	1326625617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELANIE-ANN LLANES PT

Provider Business Mailing Address
First Line	:	39 TERHUNE AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07305-4682
Country	:	US
Telephone Number	:	201-600-9883
Fax Number	:

Provider Business Practice Location Address
First Line	:	39 TERHUNE AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07305-4682
Country	:	US
Telephone Number	:	201-600-9883
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2021
Last Update Date	:	03/24/2021

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