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NPI Code Detail

MEDICARE: MRS. IVELISSE M RIMA DDS

MEDICARE:  MRS. IVELISSE M RIMA  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist036939NY

General Provider Information

NPI Number : 1679627632
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. IVELISSE M RIMA DDS
Provider Business Mailing Address
First Line : 3715 87TH STREET
Second Line : 2ND FLOOR
City : JACKSON HEIGHTS
State : NY
Zip : 11372-7534
Country : US
Telephone Number : 718-476-9244
Fax Number : 718-651-3814
Provider Business Practice Location Address
First Line : 3715 87TH STREET
Second Line : 2ND FLOOR
City : JACKSON HEIGHTS
State : NY
Zip : 11372
Country : US
Telephone Number : 718-476-9244
Fax Number : 718-651-3814
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. IVELISSE M RIMA DDS” Practice Location

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