Provider Demographics
NPI:1710693098
Name:VAZQUEZ, MELISSA (PA(ASCP))
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:PA(ASCP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7621 MAPLESHIRE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-9078
Mailing Address - Country:US
Mailing Address - Phone:919-780-9300
Mailing Address - Fax:
Practice Address - Street 1:7621 MAPLESHIRE DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-9078
Practice Address - Country:US
Practice Address - Phone:919-780-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Q00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Pathology