Provider Demographics
NPI:1578557625
Name:CIMENT, AVRAHAM YITZCHAK (DPM)
Entity Type:Individual
Prefix:
First Name:AVRAHAM
Middle Name:YITZCHAK
Last Name:CIMENT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-2631
Mailing Address - Country:US
Mailing Address - Phone:718-589-8324
Mailing Address - Fax:718-378-2880
Practice Address - Street 1:731 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-2631
Practice Address - Country:US
Practice Address - Phone:718-563-0003
Practice Address - Fax:718-378-2880
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005916213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00665274Medicaid
NYU97450Medicare UPIN