Healthcare Provider Details

I. General information

NPI: 1831509751
Provider Name (Legal Business Name): PARISS MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2014
Last Update Date: 04/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 MADISON AVE 6TH FLOOR
NEW YORK NY
10022-5403
US

IV. Provider business mailing address

PO BOX 1357
BAYVILLE NY
11709-0357
US

V. Phone/Fax

Practice location:
  • Phone: 212-752-6770
  • Fax: 212-754-0369
Mailing address:
  • Phone: 516-794-4161
  • Fax: 516-794-9568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number1992981
License Number StateNY

VIII. Authorized Official

Name: DR. VICKI L SEIDENBERG
Title or Position: OWNER
Credential: M.D.
Phone: 646-263-4120