Individual
MELISSA PORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
731 NJ-35, OCEAN TOWNSHIP, NJ 07712
(732) 508-0999
Mailing address
60 CANNON RD, FREEHOLD, NJ 07728-1404
(732) 567-1269
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ01200300
NJ
Other
Enumeration date
09/20/2021
Last updated
09/20/2021
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