Most Relevant Information
Provider Data
| NPI Number: | 1003211186 |
| Provider Name: | MELISSA BLAIN |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/30/2014 |
| Last Updated: | 10/30/2014 |
Provider Practice Location
102 WALRAVEN DR
APT 3A
TEANECK
NJ
076665116
Practice Location Phone/Fax
| Phone: | 7327540342 |
| Fax: |
Provider Mailing Location
102 WALRAVEN DR
APT 3A
TEANECK
NJ
076665116
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |