=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689588980
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PRAGNA CHOWDARY NARNE PTA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/01/2026
-----------------------------------------------------
Last Update Date | 10/01/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1636 MONTAUK HWY STE 5
-----------------------------------------------------
City | MASTIC
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11950-3016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-399-0007
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1128 WILLIAM FLOYD PKWY
-----------------------------------------------------
City | SHIRLEY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11967-1805
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225200000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Assistant
-----------------------------------------------------
License Number | 015181
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------