Healthcare Provider Details

I. General information

NPI: 1255969507
Provider Name (Legal Business Name): NZI JACQUES PHILIPPE NIAMIEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E 210TH ST
BRONX NY
10467-2401
US

IV. Provider business mailing address

1400 PELHAM PKWY S
BRONX NY
10461-1197
US

V. Phone/Fax

Practice location:
  • Phone: 718-696-2583
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35.156157
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: