Healthcare Provider Details

I. General information

NPI: 1356279905
Provider Name (Legal Business Name): MICHELLE PARENTI
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 OSAGE LN
STATEN ISLAND NY
10312-6124
US

IV. Provider business mailing address

38 OSAGE LN
STATEN ISLAND NY
10312-6124
US

V. Phone/Fax

Practice location:
  • Phone: 917-439-3079
  • Fax:
Mailing address:
  • Phone: 917-439-3079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: