Provider Demographics
NPI:1710733977
Name:COVELLI, ADELE ELIZABETH
Entity type:Individual
Prefix:
First Name:ADELE
Middle Name:ELIZABETH
Last Name:COVELLI
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 1:400 FARMERS AVE
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-3811
Mailing Address - Country:US
Mailing Address - Phone:516-941-6190
Mailing Address - Fax:
Practice Address - Street 1:12 E JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3141
Practice Address - Country:US
Practice Address - Phone:516-739-2408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071472183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist