Provider Demographics
NPI:1780024398
Name:BARRELLA, LUCIA ROSE
Entity Type:Individual
Prefix:MISS
First Name:LUCIA
Middle Name:ROSE
Last Name:BARRELLA
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 1:310 LOCUST DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11778-9281
Mailing Address - Country:US
Mailing Address - Phone:631-334-5729
Mailing Address - Fax:
Practice Address - Street 1:310 LOCUST DR
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778-9281
Practice Address - Country:US
Practice Address - Phone:631-334-5729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY314779164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse