Provider Demographics
NPI:1255525788
Name:CHARLES MORELLI DPM P.C.
Entity type:Organization
Organization Name:CHARLES MORELLI DPM P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:MORELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM PC
Authorized Official - Phone:914-835-6604
Mailing Address - Street 1:910 E BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-4109
Mailing Address - Country:US
Mailing Address - Phone:914-835-6604
Mailing Address - Fax:914-835-6913
Practice Address - Street 1:910 E BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-4109
Practice Address - Country:US
Practice Address - Phone:914-835-6604
Practice Address - Fax:914-835-6913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004812213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01537026Medicaid
NY480023413OtherRAILROAD MEDICARE ID
NYP08781OtherEMPIRE ID NUMBER
NYP672271OtherOXFORD ID NUMBER
NY1C5826OtherHEALTHNET ID NUMBER
NY480023413OtherRAILROAD MEDICARE ID
NYP08781OtherEMPIRE ID NUMBER
NYU06475Medicare UPIN