Provider Demographics
NPI:1871044909
Name:RELLO, NANCY M (ATC/L)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:RELLO
Suffix:
Gender:F
Credentials:ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 EASTLYN CT
Mailing Address - Street 2:
Mailing Address - City:BARDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:10954-1404
Mailing Address - Country:US
Mailing Address - Phone:718-514-0351
Mailing Address - Fax:
Practice Address - Street 1:3 EASTLYN CT
Practice Address - Street 2:
Practice Address - City:BARDONIA
Practice Address - State:NY
Practice Address - Zip Code:10954-1404
Practice Address - Country:US
Practice Address - Phone:718-514-0351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer