MEDICARE: JEREMY NEIL MELLI P.T.

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	40QA01508500	NJ

General Provider Information

NPI Number	:	1811321961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEREMY NEIL MELLI P.T.

Provider Business Mailing Address
First Line	:	3860 BAYSHORE RD STE F
Second Line	:
City	:	NORTH CAPE MAY
State	:	NJ
Zip	:	08204-3267
Country	:	US
Telephone Number	:	609-525-4510
Fax Number	:	609-795-7037

Provider Business Practice Location Address
First Line	:	3860 BAYSHORE RD STE F
Second Line	:
City	:	NORTH CAPE MAY
State	:	NJ
Zip	:	08204-3267
Country	:	US
Telephone Number	:	609-525-4510
Fax Number	:	609-795-7037

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

Provider Enumeration Date	:	08/26/2013
Last Update Date	:	04/17/2026

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