Healthcare Provider Details

I. General information

NPI: 1104438563
Provider Name (Legal Business Name): PATRICK RYAN PARSELL NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 08/18/2020
Certification Date: 08/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 E 102ND ST
NEW YORK NY
10029-5204
US

IV. Provider business mailing address

2177 33RD ST APT 2C
ASTORIA NY
11105-2318
US

V. Phone/Fax

Practice location:
  • Phone: 603-498-3857
  • Fax:
Mailing address:
  • Phone: 603-498-3857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number345514
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: