Provider Demographics
NPI:1285774554
Name:SCOLLAN-KOLIOPOULOS, MELISSA (EDD, APN, CDE)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:
Last Name:SCOLLAN-KOLIOPOULOS
Suffix:
Gender:F
Credentials:EDD, APN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 CHESHIRE LN
Mailing Address - Street 2:
Mailing Address - City:RINGWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07456-2743
Mailing Address - Country:US
Mailing Address - Phone:973-570-7351
Mailing Address - Fax:
Practice Address - Street 1:15 ENGLE ST STE 2ND
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2936
Practice Address - Country:US
Practice Address - Phone:201-350-7225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNN107183163WP0807X, 363LP0808X, 363LF0000X
NJNO107183163WD0400X, 174H00000X, 163WD0400X
NJNC107183364SC1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public Health
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No174H00000XOther Service ProvidersHealth Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
1285774554OtherPSYCHIATRIC MENTAL HEALTH