Carella Corporation | |
3035 Nw 63rd St Suite 103n Oklahoma City OK 73116-3632 | |
(405) 840-4212 | |
(405) 840-4258 |
Full Name | Carella Corporation |
---|---|
Speciality | Psychologist |
Location | 3035 Nw 63rd St, Oklahoma City, Oklahoma |
Authorized Official Name and Position | Stephen Daniel Carella (PRESIDENT/OWNER) |
Authorized Official Contact | 4058404212 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Carella Corporation 3035 Nw 63rd St Suite 103n Oklahoma City OK 73116-3632 Ph: (405) 840-4212 | Carella Corporation 3035 Nw 63rd St Suite 103n Oklahoma City OK 73116-3632 Ph: (405) 840-4212 |
NPI Number | 1124214440 |
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Provider Enumeration Date | 09/20/2007 |
Last Update Date | 09/20/2007 |
Medicare PECOS PAC ID | 7416132014 |
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Medicare Enrollment ID | O20110426000136 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124214440 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | 295 (Oklahoma) | Primary |
Provider Name | Stephen Carella |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1619984762 PECOS PAC ID: 5698950293 Enrollment ID: I20110426000152 |
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