Provider Demographics
NPI:1851869028
Name:TRECARTIN, MELANIE (PA)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:
Last Name:TRECARTIN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 BIG SPRING RD
Mailing Address - Street 2:
Mailing Address - City:CALIFON
Mailing Address - State:NJ
Mailing Address - Zip Code:07830-3427
Mailing Address - Country:US
Mailing Address - Phone:832-309-3434
Mailing Address - Fax:
Practice Address - Street 1:300 LITTLETON RD STE 301
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-4841
Practice Address - Country:US
Practice Address - Phone:973-755-6636
Practice Address - Fax:973-588-7672
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-06
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00024400363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MP00024400OtherNJ OFFICE OF ATTY GENERAL PA LICENSE #