Provider Demographics
NPI:1376848267
Name:NADIMI, AMIR HOSSEIN (DC)
Entity Type:Individual
Prefix:DR
First Name:AMIR
Middle Name:HOSSEIN
Last Name:NADIMI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 WOLCOTT RD
Mailing Address - Street 2:
Mailing Address - City:WOLCOTT
Mailing Address - State:CT
Mailing Address - Zip Code:06716-2673
Mailing Address - Country:US
Mailing Address - Phone:203-879-6566
Mailing Address - Fax:
Practice Address - Street 1:503 WOLCOTT RD
Practice Address - Street 2:
Practice Address - City:WOLCOTT
Practice Address - State:CT
Practice Address - Zip Code:06716-2673
Practice Address - Country:US
Practice Address - Phone:203-879-6566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-24
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1875111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor