Healthcare Provider Details

I. General information

NPI: 1811484462
Provider Name (Legal Business Name): NAURA PARE PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2018
Last Update Date: 04/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 N MAIN ST
SPRING VALLEY NY
10977-4020
US

IV. Provider business mailing address

1503 BRYANT AVE
BRONX NY
10460-5954
US

V. Phone/Fax

Practice location:
  • Phone: 877-410-3222
  • Fax:
Mailing address:
  • Phone: 646-645-7904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number905008
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: