Provider Demographics
NPI:1043586944
Name:NEMES, MIKAYLA R (PA-C)
Entity Type:Individual
Prefix:MS
First Name:MIKAYLA
Middle Name:R
Last Name:NEMES
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:22 W 21ST ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-6904
Mailing Address - Country:US
Mailing Address - Phone:212-366-5100
Mailing Address - Fax:212-366-6275
Practice Address - Street 1:22 W 21ST ST
Practice Address - Street 2:SUITE 400
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6904
Practice Address - Country:US
Practice Address - Phone:212-366-5100
Practice Address - Fax:212-366-6275
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY015473-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant