Provider Demographics
NPI:1316059447
Name:KERMANI, PAULA KAY (NPP)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:KAY
Last Name:KERMANI
Suffix:
Gender:F
Credentials:NPP
Other - Prefix:MISS
Other - First Name:PAULA
Other - Middle Name:KAY
Other - Last Name:SCHIRMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:72 SADDLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-6044
Mailing Address - Country:US
Mailing Address - Phone:914-474-8453
Mailing Address - Fax:845-728-0667
Practice Address - Street 1:72 SADDLE RIDGE DR
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-6044
Practice Address - Country:US
Practice Address - Phone:914-474-8453
Practice Address - Fax:888-821-0472
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF4009151363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1299G1Medicare PIN
1033150OtherBEACON HEALTH STRAT
808034000OtherMAGELLAN
790067OtherMVP HEALTH CARE
2248022OtherCIGNA BEH HEALTH
1299G1Medicare ID - Type Unspecified