Provider Demographics
NPI:1861010704
Name:DUBBS, MELANIE
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:DUBBS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:794 FRANKLIN AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-1379
Mailing Address - Country:US
Mailing Address - Phone:201-891-6100
Mailing Address - Fax:201-891-7700
Practice Address - Street 1:794 FRANKLIN AVE STE 204
Practice Address - Street 2:
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417-1379
Practice Address - Country:US
Practice Address - Phone:201-891-6100
Practice Address - Fax:201-891-7700
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00930100225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation