Provider Demographics
NPI:1427220789
Name:MELVIN JANKOLOVITS
Entity Type:Organization
Organization Name:MELVIN JANKOLOVITS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:JANKOLOVITS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:201-348-0800
Mailing Address - Street 1:149 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-3405
Mailing Address - Country:US
Mailing Address - Phone:201-348-0800
Mailing Address - Fax:201-348-0801
Practice Address - Street 1:149 FRONT ST
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-3405
Practice Address - Country:US
Practice Address - Phone:201-348-0800
Practice Address - Fax:201-348-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ3835332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0201220001Medicare NSC