Provider Demographics
NPI:1043491855
Name:ELEANOR FELLA
Entity Type:Organization
Organization Name:ELEANOR FELLA
Other - Org Name:PAWLING FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELEANOR
Authorized Official - Middle Name:
Authorized Official - Last Name:FELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-855-1475
Mailing Address - Street 1:198 ROUTE 22
Mailing Address - Street 2:
Mailing Address - City:PAWLING
Mailing Address - State:NY
Mailing Address - Zip Code:12564-3241
Mailing Address - Country:US
Mailing Address - Phone:845-855-1475
Mailing Address - Fax:845-855-1137
Practice Address - Street 1:198 ROUTE 22
Practice Address - Street 2:
Practice Address - City:PAWLING
Practice Address - State:NY
Practice Address - Zip Code:12564-3241
Practice Address - Country:US
Practice Address - Phone:845-855-1475
Practice Address - Fax:845-855-1137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2012-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010245-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYXJW741Medicare PIN