MEDICARE: MRS. AVIVA Z. PARNES P.A.-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	002605-1	NY

General Provider Information

NPI Number	:	1437585015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AVIVA Z. PARNES P.A.-C

Provider Business Mailing Address
First Line	:	450 CLARKSON AVE
Second Line	:	BOX67
City	:	BROOKLYN
State	:	NY
Zip	:	11203-2012
Country	:	US
Telephone Number	:	718-756-3028
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 KINGSTON AVE
Second Line	:	WINGATE HEALTH CENTER
City	:	BROOKLYN
State	:	NY
Zip	:	11203-1704
Country	:	US
Telephone Number	:	718-756-3028
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2013
Last Update Date	:	09/16/2013

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