Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | 25MA09748100 | NJ |
N | 207R00000X | Internist | MD456047 | PA |
N | 111NI0900X | Internist | MD456047 | PA |
NPI | 1629342670 |
---|---|
Provider Name | Dr. Ralph Theodore Meloro |
First Address | Morris Plains, NJ 07950-3226 |
Second Address | Morris Plains, NJ 07950-3226 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2012 |
Last Update Date | 02/11/2018 |