1659533487 NPI number — MRS. MELISSA BREI WALKER R.N., A.P.N., C

Table of content: MRS. MELISSA BREI WALKER R.N., A.P.N., C (NPI 1659533487)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659533487 NPI number — MRS. MELISSA BREI WALKER R.N., A.P.N., C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WALKER
Provider First Name:
MELISSA
Provider Middle Name:
BREI
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
R.N., A.P.N., C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659533487
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1433 RINGWOOD AVE
Provider Second Line Business Mailing Address:
THE WANAQUE CENTER FOR NURSING AND REHABILITATION
Provider Business Mailing Address City Name:
HASKELL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07420-1520
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-839-2119
Provider Business Mailing Address Fax Number:
913-839-2319

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1433 RINGWOOD AVE
Provider Second Line Business Practice Location Address:
THE WANAQUE CENTER FOR NURSING AND REHABILITATION
Provider Business Practice Location Address City Name:
HASKELL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07420-1520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-839-2119
Provider Business Practice Location Address Fax Number:
913-839-2319
Provider Enumeration Date:
07/02/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0200X , with the licence number:  26NJ00164000 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com