Active NPI
Eileen Nora Rella, LMSW
- Clinical Social Worker
- Rego Park, NY
National Provider Identifier
1023336302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0693571
- Practice address
- 9745 Queens Blvd
Rego Park, NY 11374-2116 - Phone
- (718) 830-9274
- NPI assigned
- May 11, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0693571 | NY | Primary |
Addresses
Primary practice location
9745 Queens Blvd
Rego Park, NY 11374-2116
Mailing address
97-45 Queens Blvd
Rego Park, NY 11374
Phone (718) 830-9274
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0693571 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445472000000",
"number": "1023336302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "97-45 QUEENS BLVD",
"city": "REGO PARK",
"state": "NY",
"postal_code": "11374",
"telephone_number": "718-830-9274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9745 QUEENS BLVD",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113742116",
"telephone_number": "718-830-9274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RELLA",
"first_name": "EILEEN",
"middle_name": "NORA",
"name_prefix": "Mrs.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-11",
"last_updated": "2015-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "0693571",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rego Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.