Basic Information
| Provider Information | |||||||||
| NPI: | 1841666906 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CELELLA | ||||||||
| FirstName: | JOSEPH ANDREW | ||||||||
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| Credential: | AGACNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 819 WORCESTER ST | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011511045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135436820 | ||||||||
| FaxNumber: | 4135437962 | ||||||||
| Practice Location | |||||||||
| Address1: | 41 BREWSTER RD | ||||||||
| Address2: | |||||||||
| City: | BRISTOL | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060105161 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8605853313 | ||||||||
| FaxNumber: | 4135437962 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2015 | ||||||||
| LastUpdateDate: | 12/23/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 6420 | CT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.