Provider Demographics
NPI:1750509535
Name:TOMASSO, MELANIE ANN
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:ANN
Last Name:TOMASSO
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MELANIE
Other - Middle Name:ANN
Other - Last Name:TOMASSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1071 TUCKAHOE RD
Mailing Address - Street 2:
Mailing Address - City:MILMAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08340
Mailing Address - Country:US
Mailing Address - Phone:609-476-2420
Mailing Address - Fax:609-476-2420
Practice Address - Street 1:1071 TUCKAHOE RD
Practice Address - Street 2:
Practice Address - City:MILMAY
Practice Address - State:NJ
Practice Address - Zip Code:08340
Practice Address - Country:US
Practice Address - Phone:609-476-2420
Practice Address - Fax:609-476-2420
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP05317700164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse