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General NPI Number Information
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NPI Number | 1609500578
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Entity Type | Individual
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Provider Name | ARIEL MAMIYA PTA
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Gender | Female
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Dates
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Enumeration Date | 07/14/2022
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 3001 EDWARDS MILL RD STE 200
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City | RALEIGH
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State | NC
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Zip | 27612-5243
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Country | US
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Telephone | 919-863-6856
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Fax |
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Provider Business Mailing Address
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Address Line | 3001 EDWARDS MILL RD STE 200
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City | RALEIGH
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State | NC
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Zip | 27612-5243
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Country | US
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Telephone | 919-780-5600
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Fax | 919-863-6821
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 2169579
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | A8566
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License Number State | NC
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