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NPI 1386811479

NPI 1386811479 : CHARLES P KIMMELMAN MD FACS PC : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1386811479
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    Entity Type          |    Organization 
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    Legal Business Name  |    CHARLES P KIMMELMAN MD FACS PC 
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Dates
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    Enumeration Date     |    05/08/2008
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    Last Update Date     |    11/04/2008
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Provider Practice Location Address
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    Address Line         |    993 PARK AVE STE C
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10028-0809
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    Country              |    US
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    Telephone            |    212-717-7262
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    Fax                  |    212-717-1307
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Provider Business Mailing Address
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    Address Line         |    993 PARK AVE STE C
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10028-0809
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    Country              |    US
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    Telephone            |    212-717-7262
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    Fax                  |    212-717-1307
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    DR. CHARLES PAUL KIMMELMAN 
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    Credential           |    MD
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    Telephone            |    212-717-7262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207YS0012X
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    Taxonomy Name        |    Sleep Medicine (Otolaryngology) Physician
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    License Number       |    
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    License Number State |    
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