Healthcare Provider Details

I. General information

NPI: 1316084692
Provider Name (Legal Business Name): RUTHANN PARISE DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

484 HEMPSTEAD AVENUE
MALVERNE NY
11565-1227
US

IV. Provider business mailing address

484 HEMPSTEAD AVE
MALVERNE NY
11565-1227
US

V. Phone/Fax

Practice location:
  • Phone: 516-593-8585
  • Fax: 516-596-1433
Mailing address:
  • Phone: 516-593-8585
  • Fax: 516-596-1433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN005338
License Number StateNY

VIII. Authorized Official

Name: RUTHANN PARISE
Title or Position: OWNER
Credential: DPM
Phone: 516-593-8585