Individual
MR. MICHAEL VICTOR RELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5316 NESCONSET HWY, PORT JEFF STA, NY 11776-2591
(631) 689-7800
Mailing address
24 SYLVAN LN, MILLER PLACE, NY 11764-1536
(631) 764-1355
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
310394
NY
Other
Enumeration date
03/15/2022
Last updated
03/15/2022
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