Individual
MS. MELISSA DENNISTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN -FAMILY PRACTICE
Contact information
Practice address
18-20 LACKAWANNA PLZ STE 300, MONTCLAIR, NJ 07042-3642
(347) 209-0881
(973) 869-2532
Mailing address
42 SUNNYSIDE TER, EAST ORANGE, NJ 07018-2394
(973) 392-2058
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ15130800
NJ
363LF0000X
Family Nurse Practitioner
Primary
26NJ15130800
NJ
Other
Enumeration date
09/03/2024
Last updated
05/13/2026
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