Provider Demographics
NPI:1467061499
Name:RELLA, CORINA MARGARITA (NP)
Entity Type:Individual
Prefix:
First Name:CORINA
Middle Name:MARGARITA
Last Name:RELLA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8505 108TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-1226
Mailing Address - Country:US
Mailing Address - Phone:929-635-8178
Mailing Address - Fax:
Practice Address - Street 1:287 PARK AVE S FL 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4573
Practice Address - Country:US
Practice Address - Phone:888-553-2823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11008347207RN0300X
NY350860363LF0000X
NYF350860-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology