Provider Demographics
NPI:1063680007
Name:ANDERSON, MELISSA S (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:S
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 STATION RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07832-2438
Mailing Address - Country:US
Mailing Address - Phone:908-752-0063
Mailing Address - Fax:
Practice Address - Street 1:152 STATE ROUTE 94
Practice Address - Street 2:
Practice Address - City:BLAIRSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07825-2122
Practice Address - Country:US
Practice Address - Phone:908-362-9388
Practice Address - Fax:908-362-9372
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02960200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI02960200OtherPHARMACY LICENCSE