Provider Demographics
NPI:1992007942
Name:PETRELLA, RENA (MD)
Entity Type:Individual
Prefix:DR
First Name:RENA
Middle Name:
Last Name:PETRELLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10 COTTAGE PL
Mailing Address - Street 2:APT 3E
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-1510
Mailing Address - Country:US
Mailing Address - Phone:800-969-9933
Mailing Address - Fax:212-698-0305
Practice Address - Street 1:521 W 57TH ST
Practice Address - Street 2:GENZYME GENETICS
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2929
Practice Address - Country:US
Practice Address - Phone:800-969-9933
Practice Address - Fax:212-698-0305
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-24
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY170685207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)