Provider Demographics
NPI:1609169887
Name:GRELLO, SANDRA A (CRNP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:A
Last Name:GRELLO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1240 S CEDAR CREST BLVD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6369
Mailing Address - Country:US
Mailing Address - Phone:610-402-1757
Mailing Address - Fax:610-402-9089
Practice Address - Street 1:1245 S CEDAR CREST BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6258
Practice Address - Country:US
Practice Address - Phone:610-402-1757
Practice Address - Fax:610-402-9089
Is Sole Proprietor?:No
Enumeration Date:2011-05-23
Last Update Date:2013-06-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PASP011274363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily