Provider Demographics
NPI:1104693944
Name:MARELLA, EMMA ROSE
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:ROSE
Last Name:MARELLA
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:PO BOX 84
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:MA
Mailing Address - Zip Code:01450-0084
Mailing Address - Country:US
Mailing Address - Phone:978-350-3536
Mailing Address - Fax:
Practice Address - Street 1:320 OLD AYER RD
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:MA
Practice Address - Zip Code:01450-1824
Practice Address - Country:US
Practice Address - Phone:978-350-3536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula