Provider Demographics
NPI:1982722583
Name:FRATTARELLI, MELISSA NICOLE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:NICOLE
Last Name:FRATTARELLI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:NICOLE
Other - Last Name:DEAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:740 S NEW ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-3571
Mailing Address - Country:US
Mailing Address - Phone:302-674-0222
Mailing Address - Fax:302-674-0200
Practice Address - Street 1:740 S NEW ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3571
Practice Address - Country:US
Practice Address - Phone:302-674-0222
Practice Address - Fax:302-674-0200
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC50000505363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant