Basic Information
Provider Information
NPI: 1225233141
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PARRELLA
FirstName: DAVID
MiddleName: T
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 43 WESTMINSTER AVE
Address2:  
City: BERGENFIELD
State: NJ
PostalCode: 076213913
CountryCode: US
TelephoneNumber: 2013871957
FaxNumber: 2013871936
Practice Location
Address1: 211 61 STREET
Address2: 1ST FLOOR
City: BROOKLYN
State: NY
PostalCode: 11220
CountryCode: US
TelephoneNumber: 7186301270
FaxNumber: 2013510656
Other Information
ProviderEnumerationDate: 06/20/2007
LastUpdateDate: 08/07/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0204X281038-1NYN Allopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
2085R0204X25MA08959700NJN Allopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
2084V0102X25MA08959700NJN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
2084V0102X281038-1NYY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology

No ID Information.


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