Provider Demographics
NPI:1437363538
Name:NEIMAN, ELI S (DO)
Entity Type:Individual
Prefix:DR
First Name:ELI
Middle Name:S
Last Name:NEIMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19376 DELAWARE CIR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-2668
Mailing Address - Country:US
Mailing Address - Phone:845-267-3382
Mailing Address - Fax:
Practice Address - Street 1:80 WILDER RD
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-1511
Practice Address - Country:US
Practice Address - Phone:845-354-6257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB084832002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0177750Medicaid
NJ0177750Medicaid