Provider Demographics
NPI:1710025531
Name:NIMOH, ANTHONY A
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:A
Last Name:NIMOH
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 1:1402 WAYCROSS RD
Mailing Address - Street 2:APT. A
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-2925
Mailing Address - Country:US
Mailing Address - Phone:513-322-3308
Mailing Address - Fax:
Practice Address - Street 1:1402 WAYCROSS RD
Practice Address - Street 2:APT. A
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-2925
Practice Address - Country:US
Practice Address - Phone:513-322-3308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide