Provider Demographics
NPI:1104598606
Name:PELZER, CELENA
Entity type:Individual
Prefix:MISS
First Name:CELENA
Middle Name:
Last Name:PELZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4215 PARK AVE APT 6C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-6058
Mailing Address - Country:US
Mailing Address - Phone:914-999-0309
Mailing Address - Fax:
Practice Address - Street 1:4215 PARK AVE APT 6C
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-6058
Practice Address - Country:US
Practice Address - Phone:914-999-0309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-02
Last Update Date:2021-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier