Provider Demographics
NPI:1396341137
Name:PROSPERI, MELISSA (ACHE,ATSA)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:PROSPERI
Suffix:
Gender:F
Credentials:ACHE,ATSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 CABLE AVE
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08722-3542
Mailing Address - Country:US
Mailing Address - Phone:848-333-2926
Mailing Address - Fax:
Practice Address - Street 1:313 W WATER ST STE 1
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-6693
Practice Address - Country:US
Practice Address - Phone:848-333-2926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-08
Last Update Date:2021-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase ManagementGroup - Single Specialty