Provider Demographics
NPI:1376548032
Name:PATELLI, ANNAMARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNAMARIA
Middle Name:
Last Name:PATELLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1046 ESTHER ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-1407
Mailing Address - Country:US
Mailing Address - Phone:516-775-9292
Mailing Address - Fax:516-775-9294
Practice Address - Street 1:1046 ESTHER ST
Practice Address - Street 2:JEMTEL MED, P.C.
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-1407
Practice Address - Country:US
Practice Address - Phone:516-775-9292
Practice Address - Fax:516-775-9294
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-17
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174819207R00000X
CT028700207R00000X
PAMD040897L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD92247Medicare UPIN
04F201Medicare ID - Type Unspecified