Individual
CARLA RODRIGUES MARRELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11050 MT BELVEDERE BLVD, FORT DRUM, NY 13602-2603
(315) 772-2778
Mailing address
9693A FITZSIMMONS LOOP, FORT DRUM, NY 13603-3208
(845) 633-3117
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
434652
NY
163W00000X
Registered Nurse
746232
NY
164W00000X
Licensed Practical Nurse
332840
NY
363A00000X
Physician Assistant
Primary
033168
NY
Other
Enumeration date
02/14/2024
Last updated
01/20/2025
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