Individual
MELISSA RISOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
27OA00568500
NJ
152W00000X
Optometrist
Primary
OEG000239
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016038600001
—
PA
05
—
8316309
—
NJ
Enumeration date
06/17/2005
Last updated
06/04/2019
Update your record
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