MEDICARE: MELISSA DONADIO PSY.D

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	103TC0700X	Clinical Psychologist	35S100722800	NJ

General Provider Information

NPI Number	:	1518731322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA DONADIO PSY.D

Provider Business Mailing Address
First Line	:	17 8TH ST
Second Line	:
City	:	HAZLET TOWNSHIP
State	:	NJ
Zip	:	07734-3039
Country	:	US
Telephone Number	:	732-687-3591
Fax Number	:

Provider Business Practice Location Address
First Line	:	17 8TH ST
Second Line	:
City	:	HAZLET TOWNSHIP
State	:	NJ
Zip	:	07734-3039
Country	:	US
Telephone Number	:	732-687-3591
Fax Number	:

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

Provider Enumeration Date	:	11/13/2023
Last Update Date	:	11/13/2023

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