Provider Demographics
NPI:1558375253
Name:RELLOSA, ISABELITA C
Entity Type:Individual
Prefix:DR
First Name:ISABELITA
Middle Name:C
Last Name:RELLOSA
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:ISABELITA
Other - Middle Name:CORDOBA
Other - Last Name:RELLOSA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:385 TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-1023
Mailing Address - Country:US
Mailing Address - Phone:973-676-1000
Mailing Address - Fax:973-395-7076
Practice Address - Street 1:385 TREMONT AVE
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-1023
Practice Address - Country:US
Practice Address - Phone:973-676-1000
Practice Address - Fax:973-395-7076
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02800100207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology