Provider Demographics
NPI:1326395401
Name:BOBE, MELODY
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:
Last Name:BOBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 MAHAR AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-1309
Mailing Address - Country:US
Mailing Address - Phone:862-220-2690
Mailing Address - Fax:
Practice Address - Street 1:58 MAHAR AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-1309
Practice Address - Country:US
Practice Address - Phone:862-220-2690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist