Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | N005338 | NY |
Y | 222Z00000X | Podiatrist | N005338 | NY |
NPI | 1003992041 |
---|---|
Provider Name | Ruthann Parise |
First Address | Malverne, NY 11565-1227 |
Second Address | Malverne, NY 11565-1227 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2006 |
Last Update Date | 28/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01912821 | (05) | NY |
U65501 | (02) | NY |