Provider Demographics
NPI:1457496093
Name:NASSANEY, MELISSA S (DPT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:S
Last Name:NASSANEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:WEST KINGSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02892-1079
Mailing Address - Country:US
Mailing Address - Phone:401-265-6686
Mailing Address - Fax:401-320-7208
Practice Address - Street 1:469 CENTERVILLE RD STE 101
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4355
Practice Address - Country:US
Practice Address - Phone:401-320-7101
Practice Address - Fax:401-320-7208
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT01896225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI659004064Medicare ID - Type Unspecified
RI412659OtherBLUECHIP