Provider Demographics
NPI:1447850599
Name:READE, MELISSA AYN (MS, CNS)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:AYN
Last Name:READE
Suffix:
Gender:F
Credentials:MS, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 GOLF VIEW DR
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-2820
Mailing Address - Country:US
Mailing Address - Phone:516-512-1513
Mailing Address - Fax:
Practice Address - Street 1:143 GOLF VIEW DR
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-2820
Practice Address - Country:US
Practice Address - Phone:516-512-1513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist