1891070173 NPI number — MS. MELANIE ANN SAVOY

Table of content: MS. MELANIE ANN SAVOY (NPI 1891070173)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891070173 NPI number — MS. MELANIE ANN SAVOY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAVOY
Provider First Name:
MELANIE
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SHORTALL
Provider Other First Name:
MELANIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LADC, CRC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1891070173
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/06/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5 NEPONSET ST FL STREET2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WORCESTER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01606-2714
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-368-5532
Provider Business Mailing Address Fax Number:
617-849-7113

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
225 NEW LANCASTER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEOMINSTER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01453-4958
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-534-6000
Provider Business Practice Location Address Fax Number:
617-849-7113
Provider Enumeration Date:
10/18/2011

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: 101YA0400X , with the licence number:  CDP00578 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225C00000X , with the licence number: 00115909 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YA0400X , with the licence number: 16200 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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