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Individual
MR. TYLER DEAN MELNICOVE
Active
Individual
MR. TYLER DEAN MELNICOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, EMT
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
608409
NJ
2255A2300X
Athletic Trainer
Primary
2000025437
NJ
Other
Enumeration date
04/23/2015
Last updated
09/19/2016
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