Healthcare Provider Details
I. General information
NPI: 1467839035
Provider Name (Legal Business Name): NATALIA RIMAREVA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/02/2015
Last Update Date: 05/04/2020
Certification Date: 05/04/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
121 DEKALB AVE THE BROOKLYN HOSPITAL CENTER
BROOKLYN NY
11201-5425
US
IV. Provider business mailing address
143 MORGAN ST APT 3B
JERSEY CITY NJ
07302-5901
US
V. Phone/Fax
- Phone: 718-250-8000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 289765 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: