Provider Demographics
NPI:1225011273
Name:PRESTIPINO, MELISSA (PT)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:PRESTIPINO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MAIN ST
Mailing Address - Street 2:APARTMENT # 8
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-1929
Mailing Address - Country:US
Mailing Address - Phone:973-729-6354
Mailing Address - Fax:
Practice Address - Street 1:66 SUNSET STRIP
Practice Address - Street 2:SUITE, 204, ROUTE 10 EAST
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876-1345
Practice Address - Country:US
Practice Address - Phone:973-598-9111
Practice Address - Fax:973-598-9110
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist