Provider Demographics
NPI:1013293398
Name:MELUSKY, ROBERT L (ATC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:L
Last Name:MELUSKY
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 ROUTE 601
Mailing Address - Street 2:
Mailing Address - City:SKILLMAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08558-2119
Mailing Address - Country:US
Mailing Address - Phone:609-466-7602
Mailing Address - Fax:
Practice Address - Street 1:1016 ROUTE 601
Practice Address - Street 2:
Practice Address - City:SKILLMAN
Practice Address - State:NJ
Practice Address - Zip Code:08558-2119
Practice Address - Country:US
Practice Address - Phone:609-466-7602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT000498002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer