Provider Demographics
NPI:1689408197
Name:PARES, NYDIA D (RN)
Entity type:Individual
Prefix:
First Name:NYDIA
Middle Name:D
Last Name:PARES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 SHERATON DR
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-5425
Mailing Address - Country:US
Mailing Address - Phone:845-668-0116
Mailing Address - Fax:
Practice Address - Street 1:12 SHERATON DR
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-5425
Practice Address - Country:US
Practice Address - Phone:845-668-0116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY799829163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse