Doctor Name: | MRS. TANIA M PARISE |
NPI Number: | 1063559177 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | PT 21340 |
Business Practice Address: | 1st Medical Group 45 Pine Rd Langley Afb, VA - 236652080 |
Business Phone Number: | 7577646963 |
Business Fax Number: | 7577640975 |
Mailing Address: | 1st Medical Group, 45 Pine Rd LANGLEY AFB |
State: | VA |
Postal Code: | 236652080 |
Phone Number: | 7577646963 |
Fax Number: | 7577640975 |
NPI Enumeration Date: | 01/30/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171000000X |
License Number: | PT 21340 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Military Health Care Provider |
Taxonomy Specialization: | |
Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |