Healthcare Provider Details

I. General information

NPI: 1104524347
Provider Name (Legal Business Name): MICHELLE PARELLO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2023
Last Update Date: 02/17/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1270 FLORENCE AVE
PLAINFIELD NJ
07060-3206
US

IV. Provider business mailing address

1270 FLORENCE AVE
PLAINFIELD NJ
07060-3206
US

V. Phone/Fax

Practice location:
  • Phone: 908-591-0839
  • Fax:
Mailing address:
  • Phone: 908-591-0839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: