Provider Demographics
NPI:1114289584
Name:ARELLANO, ANA
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:ARELLANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4725 48TH ST
Mailing Address - Street 2:2A
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-6644
Mailing Address - Country:US
Mailing Address - Phone:718-779-8800
Mailing Address - Fax:718-779-2070
Practice Address - Street 1:4725 48TH ST
Practice Address - Street 2:2A
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-6644
Practice Address - Country:US
Practice Address - Phone:718-779-8800
Practice Address - Fax:718-779-2070
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator