Provider Demographics
NPI:1760694103
Name:POSLUSZNY, MELISSA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:POSLUSZNY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 APACHE DR
Mailing Address - Street 2:
Mailing Address - City:SHICKSHINNY
Mailing Address - State:PA
Mailing Address - Zip Code:18655-4109
Mailing Address - Country:US
Mailing Address - Phone:570-256-4357
Mailing Address - Fax:570-256-4358
Practice Address - Street 1:149 S HUNTER HWY
Practice Address - Street 2:RTE 309
Practice Address - City:DRUMS
Practice Address - State:PA
Practice Address - Zip Code:18222-2422
Practice Address - Country:US
Practice Address - Phone:570-788-7321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-06
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC005720L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist