Healthcare Provider Details

I. General information

NPI: 1740764562
Provider Name (Legal Business Name): MS. PAIRPLOY LIMPRAPHANONTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2018
Last Update Date: 09/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 N MAIN ST
SPRING VALLEY NY
10977-4020
US

IV. Provider business mailing address

10 BELLOWS LN
MONSEY NY
10952-5202
US

V. Phone/Fax

Practice location:
  • Phone: 814-084-5363
  • Fax:
Mailing address:
  • Phone: 845-558-2025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number675240
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: