Provider Demographics
NPI:1801355094
Name:MELE, KYLE
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:MELE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 ROUTE 3
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3928
Mailing Address - Country:US
Mailing Address - Phone:908-904-1900
Mailing Address - Fax:908-904-1908
Practice Address - Street 1:1700 ROUTE 3
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3928
Practice Address - Country:US
Practice Address - Phone:908-904-1900
Practice Address - Fax:908-904-1908
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA12449700207L00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology