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Individual

DR. SCOTT JASON MELLENDER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
125 PATERSON ST # 3100, NEW BRUNSWICK, NJ 08901-1962
(732) 235-6153
Mailing address
41 LIBERTY WAY, SOUTH BOUND BROOK, NJ 08880-1494
(914) 420-5680

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA07582100
NJ
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
25MA07582100
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0236268
NJ
01
P00953299
RR MCR PTAN
NJ
Enumeration date
09/03/2008
Last updated
09/21/2011
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