Individual
MRS. MELISSA PETRONELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1255 RARITAN RD STE F4B, CLARK, NJ 07066
(848) 206-0078
(848) 206-0078
Mailing address
1345 RXR PLZ FL 13, UNIONDALE, NY 11556-1301
(516) 453-0435
(646) 846-3283
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00221000
NJ
363AS0400X
Surgical Physician Assistant
25MP00221000
NJ
Other
Enumeration date
07/31/2009
Last updated
05/16/2019
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