Melillo, Mark
Melillo, Mark is an sole proprietor health care provider with primary practice located at 1 Monument Drive , Princeton NJ 08540-4014. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Melillo, Mark can be contacted via phone (609) 924-8018.Contact Information
Primary practice address
1 Monument Drive
Princeton NJ 08540-4014
Phone: (609) 924-8018
Fax: (609) 688-2045
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 37LC00252200 | New Jersey |
Profile Details
| NPI number | 1174978159 |
|---|---|
| LBN Legal business name | Melillo, Mark |
| Credentials | MS, LCADC, RYT-200 |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 27th, 2016 |
| Last updated | Jan 13th, 2017 - about 9 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 | 1174978159 | NPPES |
| New Jersey | MEDICAID | 1174978159 |
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