Healthcare Provider Details

I. General information

NPI: 1174837348
Provider Name (Legal Business Name): BINYOMIN NEMON, D.O., PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2010
Last Update Date: 11/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

580 CROWN ST APT 611
BROOKLYN NY
11213-5358
US

IV. Provider business mailing address

580 CROWN ST APT 611
BROOKLYN NY
11213-5358
US

V. Phone/Fax

Practice location:
  • Phone: 845-791-9277
  • Fax: 845-468-5860
Mailing address:
  • Phone: 845-791-9277
  • Fax: 845-468-5860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number211250
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number211250
License Number StateNY

VIII. Authorized Official

Name: DR. BINYOMIN NEMON
Title or Position: OWNER/MEDICAL DIRECTOR
Credential: D.O.
Phone: 845-791-9277