Provider Demographics
NPI:1336755123
Name:PAREDES, EUNICE ISABEL
Entity Type:Individual
Prefix:
First Name:EUNICE
Middle Name:ISABEL
Last Name:PAREDES
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 1:1895 UNIVERSITY AVE APT 6D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-4475
Mailing Address - Country:US
Mailing Address - Phone:929-316-5518
Mailing Address - Fax:
Practice Address - Street 1:1895 UNIVERSITY AVE APT 6D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4475
Practice Address - Country:US
Practice Address - Phone:929-316-5518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY339122164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse