Provider Demographics
NPI:1285672790
Name:MARCELLA RANGEL, DPT, P.C.
Entity Type:Organization
Organization Name:MARCELLA RANGEL, DPT, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:RANGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:917-816-4676
Mailing Address - Street 1:69-45 108TH STREET
Mailing Address - Street 2:UNIT 7E
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375
Mailing Address - Country:US
Mailing Address - Phone:917-816-4676
Mailing Address - Fax:
Practice Address - Street 1:69-45 108TH STREET
Practice Address - Street 2:UNIT 7E
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375
Practice Address - Country:US
Practice Address - Phone:917-816-4676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARCELLA RANGEL, DPT, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-04
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022679-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQM6171Medicare ID - Type Unspecified
NYQ7W3D1Medicare PIN