Most Relevant Information
Provider Data
NPI Number: | 1003178823 |
Provider Name: | RENELLY MOREL |
Entity Type: | Individual |
Taxonomy Code: | 174400000X |
Specialty: | Specialist |
License Number: |
Most Important Dates
Enumeration Date: | 06/08/2012 |
Last Updated: | 06/08/2012 |
Provider Practice Location
31 GRIDLEY AVE
STATEN ISLAND
NY
103032203
Practice Location Phone/Fax
Phone: | 3479512672 |
Fax: |
Provider Mailing Location
31 GRIDLEY AVE
STATEN ISLAND
NY
103032203
Provider Mailing Phone/Fax
Phone: | 3479512672 |
Fax: |