Provider Demographics
NPI:1669598868
Name:SAVICKI, MELISSA JANE (PA)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:JANE
Last Name:SAVICKI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1076 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-5760
Mailing Address - Country:US
Mailing Address - Phone:401-273-2460
Mailing Address - Fax:401-273-2489
Practice Address - Street 1:1076 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-5760
Practice Address - Country:US
Practice Address - Phone:401-273-2460
Practice Address - Fax:401-273-2489
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPA00231363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical