Provider Demographics
NPI:1619759123
Name:NEIMAN, CHAIM
Entity Type:Individual
Prefix:
First Name:CHAIM
Middle Name:
Last Name:NEIMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 HALLEY DR
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-2108
Mailing Address - Country:US
Mailing Address - Phone:718-213-3530
Mailing Address - Fax:
Practice Address - Street 1:3231 CENTRAL PARK W STE 106
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-3009
Practice Address - Country:US
Practice Address - Phone:888-389-2095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1689378861324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility