Provider Demographics
NPI:1679807390
Name:RANKEL, MARCELLA ANNE
Entity Type:Individual
Prefix:MRS
First Name:MARCELLA
Middle Name:ANNE
Last Name:RANKEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:EASTPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11941-1424
Mailing Address - Country:US
Mailing Address - Phone:631-801-2044
Mailing Address - Fax:
Practice Address - Street 1:366 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:EASTPORT
Practice Address - State:NY
Practice Address - Zip Code:11941-1424
Practice Address - Country:US
Practice Address - Phone:631-801-2044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-28
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY230549-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse