Provider Demographics
NPI:1447240817
Name:KAVITSKY, MELANIE KARA (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:KARA
Last Name:KAVITSKY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:MELANIE
Other - Middle Name:KARA
Other - Last Name:NAROD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:647 VALLEY STREAM CIRCLE
Mailing Address - Street 2:
Mailing Address - City:LANGEHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19053
Mailing Address - Country:US
Mailing Address - Phone:215-891-9982
Mailing Address - Fax:
Practice Address - Street 1:416 BELLEVUE AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618
Practice Address - Country:US
Practice Address - Phone:609-396-4700
Practice Address - Fax:609-396-4900
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN533110163W00000X
PA075022367500000X
NJ163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered