Davidson, Melissa
Davidson, Melissa is an individual health care provider with primary practice located at 370 Grand Avenue Ste 203, Englewood NJ 07631. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Adolescent Medicine. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Davidson, Melissa can be contacted via phone (201) 568-3262.Contact Information
Primary practice address
370 Grand Avenue Ste 203
Englewood NJ 07631
Phone: (201) 568-3262
Fax: (201) 589-2634
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MA056284 | New Jersey |
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | MA056284 | New Jersey |
Profile Details
| NPI number | 1467410043 |
|---|---|
| LBN Legal business name | Davidson, Melissa |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 3rd, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467410043 | NPPES |
| Other | BP169 | OXFORD | |
| MEDICAID | 4573706 | OXFORD |
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