Provider Demographics
NPI:1609181379
Name:LAMELZA, MATTHEW N
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:N
Last Name:LAMELZA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 ATLANTIC AVE
Mailing Address - Street 2:UNIT C
Mailing Address - City:OCEAN CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08226-4361
Mailing Address - Country:US
Mailing Address - Phone:609-398-1368
Mailing Address - Fax:
Practice Address - Street 1:RITE AID #116 907 N HIGH ST
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332
Practice Address - Country:US
Practice Address - Phone:856-825-7742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02449200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist