Individual
DR. SHEILA RITA REBELLO-EIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
49 OAKCREST AVENUE, OAK HOLLOW NURSING CENTER, MIDDLE ISLAND, NY 11953
(631) 504-6363
Mailing address
10 EVERGREEN AVENUE, MIDDLE ISLAND, NY 11953
(631) 504-6363
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
013901
NY
103TC0700X
Clinical Psychologist
013901
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01983384
—
NY
01
—
132500
VYTRA
NY
01
—
166561P
HIP
NY
Enumeration date
10/04/2006
Last updated
12/18/2009
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