Provider Demographics
NPI:1538744610
Name:NARDA NARVAEZ
Entity type:Organization
Organization Name:NARDA NARVAEZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NARDA
Authorized Official - Middle Name:
Authorized Official - Last Name:NARVAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:917-907-1717
Mailing Address - Street 1:100 CROCUS LN
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18337-7118
Mailing Address - Country:US
Mailing Address - Phone:917-907-1717
Mailing Address - Fax:
Practice Address - Street 1:1663 E 17TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1259
Practice Address - Country:US
Practice Address - Phone:718-338-3838
Practice Address - Fax:718-339-4172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy