Provider Demographics
NPI:1134600026
Name:PARELLO, NICOLE CELESTE (MA)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:CELESTE
Last Name:PARELLO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SALZBURG CT
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-2943
Mailing Address - Country:US
Mailing Address - Phone:646-872-7108
Mailing Address - Fax:
Practice Address - Street 1:4 SALZBURG CT
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-2943
Practice Address - Country:US
Practice Address - Phone:646-872-7108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist