Healthcare Provider Details

I. General information

NPI: 1659365054
Provider Name (Legal Business Name): JULIO ANIBAL RIMARACHIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 05/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11406 QUEENS BLVD SUITE 1G
FOREST HILLS NY
11375-7001
US

IV. Provider business mailing address

11406 QUEENS BLVD SUITE 1G
FOREST HILLS NY
11375-7001
US

V. Phone/Fax

Practice location:
  • Phone: 718-275-5512
  • Fax: 718-275-5509
Mailing address:
  • Phone: 718-275-5512
  • Fax: 718-275-5509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number231549
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: