# MERLE CORTELLUCCI

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1548871643
- **Gender:** F
- **Credential:** M.S., ATC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2255A2300X | Athletic Trainer | 001767 | NY | Yes |

## Other

- **Enumeration date:** 08/12/2020
- **Last updated:** 08/12/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1009128 | NATA | — |
| 01 | — | 2000000180 | BOC | — |