Provider Demographics
NPI:1386302370
Name:PASIGNAJEN-PORMENTILLA, MELANIE LOU
Entity type:Individual
Prefix:
First Name:MELANIE LOU
Middle Name:
Last Name:PASIGNAJEN-PORMENTILLA
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 1:691B CRANBURY CROSS RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-2829
Mailing Address - Country:US
Mailing Address - Phone:347-638-9864
Mailing Address - Fax:
Practice Address - Street 1:691B CRANBURY CROSS RD
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-2829
Practice Address - Country:US
Practice Address - Phone:347-638-9864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker