Provider Demographics
NPI:1952848657
Name:MELVIN, SCHINITA A (MA,L/ATC)
Entity Type:Individual
Prefix:
First Name:SCHINITA
Middle Name:A
Last Name:MELVIN
Suffix:
Gender:F
Credentials:MA,L/ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 ABERNETHY DR
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-5003
Mailing Address - Country:US
Mailing Address - Phone:609-802-6367
Mailing Address - Fax:
Practice Address - Street 1:195 MAJOR RD
Practice Address - Street 2:
Practice Address - City:MONMOUTH JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08852-2307
Practice Address - Country:US
Practice Address - Phone:732-329-4633
Practice Address - Fax:732-329-1906
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT001003002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer