Provider Demographics
NPI:1588616437
Name:WHITMAN, MELISSA B (ATC)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:B
Last Name:WHITMAN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 HILLCROFT RD
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08009-1322
Mailing Address - Country:US
Mailing Address - Phone:856-889-6095
Mailing Address - Fax:
Practice Address - Street 1:16 HILLCROFT RD
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08009-1322
Practice Address - Country:US
Practice Address - Phone:856-889-6095
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT001094002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer