Provider Demographics
NPI:1154136109
Name:TRUJILLO CORTES, MELANI SOFIA
Entity type:Individual
Prefix:
First Name:MELANI
Middle Name:SOFIA
Last Name:TRUJILLO CORTES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 SHIPPEN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:WEEHAWKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07086-5514
Mailing Address - Country:US
Mailing Address - Phone:551-286-5641
Mailing Address - Fax:
Practice Address - Street 1:125 SHIPPEN ST APT 2
Practice Address - Street 2:
Practice Address - City:WEEHAWKEN
Practice Address - State:NJ
Practice Address - Zip Code:07086-5514
Practice Address - Country:US
Practice Address - Phone:551-286-5641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst