Provider Demographics
NPI:1831491612
Name:MELISSA RIVERA MARANO, PSY.D., LLC
Entity Type:Organization
Organization Name:MELISSA RIVERA MARANO, PSY.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:RIVERA
Authorized Official - Last Name:MARANO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:732-761-1900
Mailing Address - Street 1:501 IRON BRIDGE RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-5304
Mailing Address - Country:US
Mailing Address - Phone:732-761-1900
Mailing Address - Fax:732-761-2388
Practice Address - Street 1:501 IRON BRIDGE RD
Practice Address - Street 2:SUITE 6
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-5304
Practice Address - Country:US
Practice Address - Phone:732-761-1900
Practice Address - Fax:732-761-2388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-29
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4007261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center