Provider Demographics
NPI:1235577206
Name:MAURO, MELISSA GEORGETTE (MD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:GEORGETTE
Last Name:MAURO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:15 EDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08853-4236
Mailing Address - Country:US
Mailing Address - Phone:973-945-0790
Mailing Address - Fax:610-643-4523
Practice Address - Street 1:2100 WESCOTT DR
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4604
Practice Address - Country:US
Practice Address - Phone:908-788-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN63453207R00000X
NJ25MA09857800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine