Provider Demographics
NPI:1447512645
Name:HOLMES, ARLENE MARIE
Entity type:Individual
Prefix:MS
First Name:ARLENE
Middle Name:MARIE
Last Name:HOLMES
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ARLENE
Other - Middle Name:MARIE
Other - Last Name:SCOPELLITI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS ED
Mailing Address - Street 1:50 LASER CT
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-3958
Mailing Address - Country:US
Mailing Address - Phone:631-853-2134
Mailing Address - Fax:631-853-2310
Practice Address - Street 1:50 LASER CT
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-3958
Practice Address - Country:US
Practice Address - Phone:631-853-2134
Practice Address - Fax:631-853-2310
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator