Mellul Eye & Facial Plastic Surgery, P.C.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

25MB07476600 Issued in NJ

Legal business name

MELLUL EYE & FACIAL PLASTIC SURGERY, P.C.

Practice address

525 Route 73 S Ste 305
Marlton, NJ 08053-9642

Phone

(856) 334-8227

Fax

(856) 334-8230

NPI assigned

Jul 22, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Steven D Mellul, D.O.NPI 1548261605

Title

Sole Proprietor

Phone

(856) 334-8227

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven D Mellul, D.O., FACS

  • Ophthalmology Physician
  • Marlton, NJ
  • NPI 1548261605
  Medicare reassignment NPD Authorized official
• Alexandra Renee Nicholas, APN

  • Acute Care Nurse Practitioner
  • Cherry Hill, NJ
  • NPI 1093539249
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367366400000",
    "number": "1750302808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 ROUTE 73 S STE 305A",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080539644",
            "telephone_number": "856-334-8227",
            "fax_number": "856-334-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 ROUTE 73 S STE 305",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080539642",
            "telephone_number": "856-334-8227",
            "fax_number": "856-334-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELLUL EYE & FACIAL PLASTIC SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2013-05-01",
        "status": "A",
        "authorized_official_last_name": "MELLUL",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "856-334-8227",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MB07476600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "089174",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018198",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amina Mehrab, M.D
• Anokhi D. Mehta, MD
• Carlo Bruno Melini, MD
• Melissa Acquavella-Lightfoot, LLC (New Patterns Psychology)
• Melissa B. Citron, LPC, LLC (Melissa Citron Counseling)
• Steven D Mellul, D.O., FACS
• Melvyn a Blake DDS PC
• Michael D. Melzer, OD
• Susan Melzer, L.C.S.W.
• Merakey New Jersey

• Ophthalmology Physician in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Ophthalmology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.