Individual
MRS. ELENA BORRELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
13719 23 MILE RD # 146, SHELBY TOWNSHIP, MI 48315-2907
(248) 266-1355
Mailing address
13719 23 MILE RD, STE 146, SHELBY TOWNSHIP, MI 48315-2907
(586) 212-6915
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601005627
MI
363AS0400X
Surgical Physician Assistant
5601005627
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12024128
CAQH
MI
Enumeration date
09/11/2009
Last updated
12/22/2021
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