Provider Demographics
NPI:1124588736
Name:NEMIROVSKY, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:NEMIROVSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 S EUTAW ST APT 1104
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1688
Mailing Address - Country:US
Mailing Address - Phone:415-676-9827
Mailing Address - Fax:
Practice Address - Street 1:11 S EUTAW ST APT 1104
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1688
Practice Address - Country:US
Practice Address - Phone:415-676-9827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program