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NPI Code Detail

MEDICARE: MRS. PENNY LEAVELLE PARHAM R.N.

MEDICARE: MRS. PENNY LEAVELLE PARHAM R.N.
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
1163WP0808XPsychiatric/Mental Health Registered Nurse199831-1NY

General Provider Information

NPI Number : 1922243732
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PENNY LEAVELLE PARHAM R.N.
Provider Business Mailing Address
First Line : 360 MAMARONECK AVE
Second Line :
City : WHITE PLAINS
State : NY
Zip : 10605-1700
Country : US
Telephone Number : 914-682-1480
Fax Number : 914-684-0937
Provider Business Practice Location Address
First Line : 360 MAMARONECK AVE
Second Line :
City : WHITE PLAINS
State : NY
Zip : 10605-1700
Country : US
Telephone Number : 914-682-1480
Fax Number : 914-684-0937
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2008
Last Update Date : 12/08/2008

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