Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 27OA00638300 | NJ |
N | 152W00000X | Optometrist | 27OA00638301 | NJ |
N | 152W00000X | Optometrist | OEG002590 | PA |
NPI | 1003176850 |
---|---|
Provider Name | Dr. Anna Greene Mellinger |
First Address | Philadelphia, PA 19104-5252 |
Second Address | Stratford, NJ 08084-1324 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2012 |
Last Update Date | 25/05/2012 |