Provider Demographics
NPI:1699444224
Name:ZAVALA, MELANIE SANTOS (WHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:SANTOS
Last Name:ZAVALA
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:GARWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07027-1125
Mailing Address - Country:US
Mailing Address - Phone:908-967-4809
Mailing Address - Fax:
Practice Address - Street 1:241 MILLBURN AVE
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1739
Practice Address - Country:US
Practice Address - Phone:862-289-6590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01459600363LW0102X
NY421505363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health