Healthcare Provider Details

I. General information

NPI: 1033534193
Provider Name (Legal Business Name): NICOLE PARAISY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2014
Last Update Date: 02/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7559 263RD ST
GLEN OAKS NY
11004-1150
US

IV. Provider business mailing address

7559 263RD ST
GLEN OAKS NY
11004-1150
US

V. Phone/Fax

Practice location:
  • Phone: 516-470-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF401620
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number545020
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: