Provider Demographics
NPI:1053396325
Name:PARNESS, IRA (MD)
Entity type:Individual
Prefix:
First Name:IRA
Middle Name:
Last Name:PARNESS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 MARCUS AVE STE M15
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1034
Mailing Address - Country:US
Mailing Address - Phone:516-601-7200
Mailing Address - Fax:516-601-1738
Practice Address - Street 1:1111 MARCUS AVE STE M15
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1034
Practice Address - Country:US
Practice Address - Phone:516-601-7200
Practice Address - Fax:516-601-1738
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-09
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1429242080P0202X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF19337Medicare UPIN