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General NPI Number Information
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NPI Number | 1841564663
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Entity Type | Individual
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Provider Name | GARY ANELLO R.N., C.D.C.E.S
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Gender | Male
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Dates
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Enumeration Date | 02/24/2012
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | PO BOX 13
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City | WEST PARK
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State | NY
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Zip | 12493-0013
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Country | US
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Telephone | 845-706-3778
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Fax | 845-384-6465
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Provider Business Mailing Address
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Address Line | PO BOX 13
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City | WEST PARK
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State | NY
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Zip | 12493-0013
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Country | US
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Telephone | 845-706-3778
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Fax | 845-384-6465
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number | 453485-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number | 20810014
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License Number State | NY
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