Organization
MELLUL EYE & FACIAL PLASTIC SURGERY, P.C.
Active
Organization
MELLUL EYE & FACIAL PLASTIC SURGERY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN D MELLUL D.O. (SOLE PROPRIETOR)
(856) 334-8227
Entity
Organization
Contact information
Practice address
525 ROUTE 73 S STE 305, MARLTON, NJ 08053-9642
(856) 334-8227
(856) 334-8230
Mailing address
525 ROUTE 73 S STE 305A, MARLTON, NJ 08053-9644
(856) 334-8227
(856) 334-8230
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
25MB07476600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018198
—
NJ
01
—
089174
MEDICARE PTAN
NJ
Enumeration date
07/22/2006
Last updated
05/01/2013
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