Provider Demographics
NPI:1063287514
Name:COMELLAS, MARICELI I (ED D)
Entity type:Individual
Prefix:DR
First Name:MARICELI
Middle Name:
Last Name:COMELLAS
Suffix:I
Gender:F
Credentials:ED D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1178 BROADWAY FL 33479
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5404
Mailing Address - Country:US
Mailing Address - Phone:646-335-2223
Mailing Address - Fax:
Practice Address - Street 1:1178 BROADWAY FL 33479
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5404
Practice Address - Country:US
Practice Address - Phone:646-335-2223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174H00000XOther Service ProvidersHealth Educator
No175T00000XOther Service ProvidersPeer Specialist