MEDICARE: DR. ETHAN JOSEPH CIMENT D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0131X	Foot Surgery Podiatrist	N005936	NY

General Provider Information

NPI Number	:	1124171806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ETHAN JOSEPH CIMENT D.P.M.

Provider Business Mailing Address
First Line	:	37 W 20TH ST
Second Line	:	SUITE 308
City	:	NEW YORK
State	:	NY
Zip	:	10011-3706
Country	:	US
Telephone Number	:	646-929-4149
Fax Number	:	347-577-9457

Provider Business Practice Location Address
First Line	:	37 W 20TH ST
Second Line	:	SUITE 308
City	:	NEW YORK
State	:	NY
Zip	:	10011-3706
Country	:	US
Telephone Number	:	646-929-4149
Fax Number	:	347-577-9457

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	02/13/2012

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