Healthcare Provider Details

I. General information

NPI: 1689588980
Provider Name (Legal Business Name): PRAGNA CHOWDARY NARNE PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1636 MONTAUK HWY STE 5
MASTIC NY
11950-3016
US

IV. Provider business mailing address

1128 WILLIAM FLOYD PKWY
SHIRLEY NY
11967-1805
US

V. Phone/Fax

Practice location:
  • Phone: 631-399-0007
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number015181
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: