Provider Demographics
NPI:1740477033
Name:DROZDA, MELISSA ANNE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANNE
Last Name:DROZDA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:ANNE
Other - Last Name:SCHUBERTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:10 BRASS CASTLE RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07882-4327
Mailing Address - Country:US
Mailing Address - Phone:908-454-5221
Mailing Address - Fax:908-454-5228
Practice Address - Street 1:755 MEMORIAL PKWY
Practice Address - Street 2:SUITE 106
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-2748
Practice Address - Country:US
Practice Address - Phone:908-454-5221
Practice Address - Fax:908-454-5228
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA053185363A00000X
NJ25MP00237200363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA188841Medicare PIN
NJ194355Medicare PIN