Provider Demographics
NPI:1215972500
Name:FLEISCHMANN, MELANIE RUTH
Entity type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:RUTH
Last Name:FLEISCHMANN
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 1:1120 COCOA AVE
Mailing Address - Street 2:COCOA FAMILY MEDICINE
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-1712
Mailing Address - Country:US
Mailing Address - Phone:717-533-4141
Mailing Address - Fax:
Practice Address - Street 1:1120 COCOA AVE
Practice Address - Street 2:COCOA FAMILY MEDICINE
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-1712
Practice Address - Country:US
Practice Address - Phone:717-533-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2017-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD429719207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H21875Medicare UPIN
NJ063800Medicare ID - Type Unspecified