Provider Demographics
NPI:1184800146
Name:FORCHIELLI DEMARS, MELISSA (PNP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:FORCHIELLI DEMARS
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:FORCHIELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:133 LITTLETON RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-3115
Mailing Address - Country:US
Mailing Address - Phone:978-577-0437
Mailing Address - Fax:978-692-4276
Practice Address - Street 1:133 LITTLETON RD
Practice Address - Street 2:SUITE 101
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-3115
Practice Address - Country:US
Practice Address - Phone:978-577-0437
Practice Address - Fax:978-692-4276
Is Sole Proprietor?:No
Enumeration Date:2008-01-21
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA252365208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics