Provider Demographics
NPI:1518408657
Name:PARKAR, KIMAYA KISHOR
Entity type:Individual
Prefix:MS
First Name:KIMAYA
Middle Name:KISHOR
Last Name:PARKAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3320 BENSON AVE
Mailing Address - Street 2:ST. ELIZABETH'S REHABILITATION AND NURSING HOME
Mailing Address - City:HALETHORPE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-1035
Mailing Address - Country:US
Mailing Address - Phone:410-644-7100
Mailing Address - Fax:
Practice Address - Street 1:3320 BENSON AVE
Practice Address - Street 2:ST. ELIZABETH'S REHABILITATION AND NURSING HOME
Practice Address - City:HALETHORPE
Practice Address - State:MD
Practice Address - Zip Code:21227-1035
Practice Address - Country:US
Practice Address - Phone:410-644-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08082225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist