Provider Demographics
NPI:1528494457
Name:WRIGHT, MELISSA A (IDMT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4259D E GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08641-1275
Mailing Address - Country:US
Mailing Address - Phone:347-255-2983
Mailing Address - Fax:
Practice Address - Street 1:4259D E GEORGE ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08641-1275
Practice Address - Country:US
Practice Address - Phone:347-255-2983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians