Provider Demographics
NPI:1154665743
Name:GAYDOS, MELISSA (NP-C)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:GAYDOS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 MORRISTOWN RD
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-1654
Mailing Address - Country:US
Mailing Address - Phone:973-527-1907
Mailing Address - Fax:
Practice Address - Street 1:131 MORRISTOWN RD
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-1654
Practice Address - Country:US
Practice Address - Phone:973-527-1907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-20
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00402900363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health