Healthcare Provider Details

I. General information

NPI: 1467551002
Provider Name (Legal Business Name): PARIS A ARIANAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1841 BRENTWOOD RD
BRENTWOOD NY
11717-4625
US

IV. Provider business mailing address

243 CONCORD AVE
W HEMPSTEAD NY
11552-1201
US

V. Phone/Fax

Practice location:
  • Phone: 631-853-7300
  • Fax:
Mailing address:
  • Phone: 516-485-3912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number193375
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: