Provider Demographics
NPI:1609320860
Name:PARSA, PARISA (FNP)
Entity Type:Individual
Prefix:
First Name:PARISA
Middle Name:
Last Name:PARSA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:PARISA
Other - Middle Name:
Other - Last Name:SALEHI-ALLAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2721 BRUNSWICK PIKE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-4106
Mailing Address - Country:US
Mailing Address - Phone:609-882-2577
Mailing Address - Fax:
Practice Address - Street 1:2721 BRUNSWICK PIKE
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-4106
Practice Address - Country:US
Practice Address - Phone:806-882-2577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-04
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016217363LF0000X
NJ26NJ01010900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily