Healthcare Provider Details

I. General information

NPI: 1962912485
Provider Name (Legal Business Name): PATRICIA PARRALES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2017
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 FOX ST PH
BRONX NY
10459-4304
US

IV. Provider business mailing address

921 FOX ST PH
BRONX NY
10459-4304
US

V. Phone/Fax

Practice location:
  • Phone: 917-673-6431
  • Fax:
Mailing address:
  • Phone: 917-673-6431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: