Provider Demographics
NPI:1316980550
Name:MASLOFF, MELVIN L (MD)
Entity type:Individual
Prefix:
First Name:MELVIN
Middle Name:L
Last Name:MASLOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2835 S DELSEA DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-7079
Mailing Address - Country:US
Mailing Address - Phone:856-205-0800
Mailing Address - Fax:856-205-0024
Practice Address - Street 1:2835 S DELSEA DR
Practice Address - Street 2:SUITE D
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-7079
Practice Address - Country:US
Practice Address - Phone:856-205-0800
Practice Address - Fax:856-205-0024
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03230100174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007679660003Medicaid
NJ2215501Medicaid
PA0400045861OtherRAILROAD MEDICARE PA
C57097Medicare UPIN
PA104147Medicare ID - Type UnspecifiedMEDICARE OF PA
PA0007679660003Medicaid