Provider Demographics
NPI:1497280283
Name:WILLIAMS, MELANIE (RD RDN)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RD RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BANFIELD CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-2542
Mailing Address - Country:US
Mailing Address - Phone:732-754-4307
Mailing Address - Fax:
Practice Address - Street 1:4 BANFIELD CT
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748-2542
Practice Address - Country:US
Practice Address - Phone:732-754-4307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-29
Last Update Date:2017-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ685075133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered