Provider Demographics
NPI:1376214007
Name:BETANCUR, MELANIE (BSPHE,MPH,CPLD)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:BETANCUR
Suffix:
Gender:F
Credentials:BSPHE,MPH,CPLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 BERKSHIRE VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:KENVIL
Mailing Address - State:NJ
Mailing Address - Zip Code:07847-2537
Mailing Address - Country:US
Mailing Address - Phone:973-459-5942
Mailing Address - Fax:
Practice Address - Street 1:45 BERKSHIRE VALLEY RD
Practice Address - Street 2:
Practice Address - City:KENVIL
Practice Address - State:NJ
Practice Address - Zip Code:07847-2537
Practice Address - Country:US
Practice Address - Phone:973-970-3586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula