Provider Demographics
NPI:1609300755
Name:OWAIS, NIMRA ALVI
Entity Type:Individual
Prefix:MRS
First Name:NIMRA
Middle Name:ALVI
Last Name:OWAIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:NIMRA
Other - Middle Name:ALVI
Other - Last Name:OWAIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:59 MYERS AVE
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-2536
Mailing Address - Country:US
Mailing Address - Phone:631-829-8838
Mailing Address - Fax:
Practice Address - Street 1:1400 OLD COUNTRY RD STE 103
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-5119
Practice Address - Country:US
Practice Address - Phone:516-806-6969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-15
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026534225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist