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General NPI Number Information
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NPI Number | 1780147892
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Entity Type | Individual
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Provider Name | NICOLE KRISTINA PARSLEY PTA
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Gender | Female
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Dates
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Enumeration Date | 04/08/2019
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Last Update Date | 07/21/2020
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Provider Practice Location Address
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Address Line | 92 SERENE PL
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City | HAUPPAUGE
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State | NY
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Zip | 11788-3535
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Country | US
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Telephone | 631-972-4263
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Fax |
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Provider Business Mailing Address
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Address Line | 7 BELL AVE
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City | BLUE POINT
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State | NY
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Zip | 11715-1106
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Country | US
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Telephone | 631-972-4263
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Fax |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 010930
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License Number State | NY
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