Provider Demographics
NPI:1669758454
Name:MARINELLI, MELANIE J (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:J
Last Name:MARINELLI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 SAVANNAH RD.
Mailing Address - Street 2:#B
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958
Mailing Address - Country:US
Mailing Address - Phone:302-645-3555
Mailing Address - Fax:302-644-3560
Practice Address - Street 1:400 SAVANNAH RD.
Practice Address - Street 2:#B
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958
Practice Address - Country:US
Practice Address - Phone:302-645-3555
Practice Address - Fax:302-644-3560
Is Sole Proprietor?:No
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0000739363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical