Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 18459 | PR |
N | 111NI0900X | Internist | 18459 | PR |
Y | 207RG0300X | Geriatric Medicine | 18459 | PR |
NPI | 1013149145 |
---|---|
Provider Name | Nicole Rassi Stella |
First Address | San Juan, PR 00929-0134 |
Second Address | San Juan, PR 00922-2116 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2009 |
Last Update Date | 29/01/2020 |