Provider Demographics
NPI:1760464929
Name:RUBIN, MELISSA HERR (MA)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:HERR
Last Name:RUBIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:HERR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:746 FITZWATER ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-2815
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:208 WHITE HORSE PIKE
Practice Address - Street 2:SUITE 7
Practice Address - City:BARRINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08007-1322
Practice Address - Country:US
Practice Address - Phone:856-546-1535
Practice Address - Fax:856-546-6565
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00058100231H00000X
NJ25MG00091400237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter