Provider Demographics
NPI:1821000746
Name:NOEL Z. RELOJ,SR, MD, PSC
Entity type:Organization
Organization Name:NOEL Z. RELOJ,SR, MD, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D./PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:ZABAL
Authorized Official - Last Name:RELOJ
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:270-769-6330
Mailing Address - Street 1:551 WESTPORT RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2920
Mailing Address - Country:US
Mailing Address - Phone:270-769-6330
Mailing Address - Fax:270-766-1232
Practice Address - Street 1:551 WESTPORT RD
Practice Address - Street 2:SUITE C
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2920
Practice Address - Country:US
Practice Address - Phone:270-769-6330
Practice Address - Fax:270-766-1032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY265362084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64265366Medicaid
KY7421Medicare PIN
KY64265366Medicaid