Healthcare Provider Details

I. General information

NPI: 1477820082
Provider Name (Legal Business Name): MS. STEPHANIE D DAYARAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2011
Last Update Date: 11/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 WILLIS AVE
ROSLYN HEIGHTS NY
11577-2125
US

IV. Provider business mailing address

216 WILLIS AVENUE
ROSLYN HEIGHTS NY
11577
US

V. Phone/Fax

Practice location:
  • Phone: 516-277-1616
  • Fax:
Mailing address:
  • Phone: 516-277-1616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number003798
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: