=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811958671
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ARUNA PAREKH MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/31/2006
-----------------------------------------------------
Last Update Date | 05/07/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | HSC 11
-----------------------------------------------------
City | STONY BROOK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11794-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-444-7653
-----------------------------------------------------
Fax | 661-444-9142
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1559 DEPARTMENT OF PEDIATRICS
-----------------------------------------------------
City | STONY BROOK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11794-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-444-0650
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 122627
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------