Provider Demographics
NPI:1356042618
Name:CIRELLI, MARY
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:CIRELLI
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 1:5498 WILSON DR
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-1539
Mailing Address - Country:US
Mailing Address - Phone:440-251-4157
Mailing Address - Fax:
Practice Address - Street 1:5498 WILSON DR
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-1539
Practice Address - Country:US
Practice Address - Phone:440-251-4157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care