Provider Demographics
NPI:1205557931
Name:WHITTLE, MELISSA
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:WHITTLE
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 1:1186 SWEDESBORO RD
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08343-4637
Mailing Address - Country:US
Mailing Address - Phone:856-723-3755
Mailing Address - Fax:856-422-0791
Practice Address - Street 1:1186 SWEDESBORO RD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08343-4637
Practice Address - Country:US
Practice Address - Phone:856-723-3755
Practice Address - Fax:856-422-0791
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty