Provider Demographics
NPI:1497100192
Name:COMRIE, PAULA DICOLA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MISS
First Name:PAULA
Middle Name:DICOLA
Last Name:COMRIE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 E 224TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-5806
Mailing Address - Country:US
Mailing Address - Phone:646-872-0201
Mailing Address - Fax:
Practice Address - Street 1:464 W 145TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-4701
Practice Address - Country:US
Practice Address - Phone:212-926-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-30
Last Update Date:2016-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF339590-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily