MEDICARE: KYLE MELE

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	207L00000X	Anesthesiology Physician	25MA12449700	NJ
2	208VP0014X	Interventional Pain Medicine Physician	25MA12449700	NJ

General Provider Information

NPI Number	:	1801355094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLE MELE

Provider Business Mailing Address
First Line	:	1700 ROUTE 3
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07013-3928
Country	:	US
Telephone Number	:	908-904-1900
Fax Number	:	908-904-1908

Provider Business Practice Location Address
First Line	:	1700 ROUTE 3
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07013-3928
Country	:	US
Telephone Number	:	908-904-1900
Fax Number	:	908-904-1908

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

Provider Enumeration Date	:	03/18/2019
Last Update Date	:	12/04/2024

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Directions to “ KYLE MELE ” Practice Location

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