Provider Demographics
NPI:1972886349
Name:PARRA, SHARY N
Entity Type:Individual
Prefix:MS
First Name:SHARY
Middle Name:N
Last Name:PARRA
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:PO BOX 267
Mailing Address - Street 2:
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523-0267
Mailing Address - Country:US
Mailing Address - Phone:917-727-6217
Mailing Address - Fax:
Practice Address - Street 1:32 N GOODWIN AVE PH
Practice Address - Street 2:
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-3114
Practice Address - Country:US
Practice Address - Phone:917-727-6217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2020-09-08
Deactivation Date:2019-01-04
Deactivation Code:
Reactivation Date:2020-08-26
Provider Licenses
StateLicense IDTaxonomies
NY095240104100000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program