Provider Demographics
NPI:1316084692
Name:RUTHANN PARISE,DPM PC
Entity type:Organization
Organization Name:RUTHANN PARISE,DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUTHANN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARISE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:516-593-8585
Mailing Address - Street 1:484 HEMPSTEAD AVENUE
Mailing Address - Street 2:
Mailing Address - City:MALVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11565
Mailing Address - Country:US
Mailing Address - Phone:516-593-8585
Mailing Address - Fax:516-596-1433
Practice Address - Street 1:484 HEMPSTEAD AVENUE
Practice Address - Street 2:
Practice Address - City:MALVERNE
Practice Address - State:NY
Practice Address - Zip Code:11565-1227
Practice Address - Country:US
Practice Address - Phone:516-593-8585
Practice Address - Fax:516-596-1433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005338213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01912821Medicaid
NYU65501Medicare UPIN
NYW99881Medicare PIN
NY01912821Medicaid