Provider Demographics
NPI:1083041131
Name:LOUIS, PRIYA PAILY
Entity Type:Individual
Prefix:MRS
First Name:PRIYA
Middle Name:PAILY
Last Name:LOUIS
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 1:757 BUCHANAN CT
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1702
Mailing Address - Country:US
Mailing Address - Phone:201-444-6199
Mailing Address - Fax:
Practice Address - Street 1:1150 SAINT NICHOLAS AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3822
Practice Address - Country:US
Practice Address - Phone:212-305-6354
Practice Address - Fax:212-851-5366
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF306008-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health