Provider Demographics
NPI:1134725401
Name:NIMBERG, JAMES
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:NIMBERG
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 1:320 7TH AVE # 245
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4194
Mailing Address - Country:US
Mailing Address - Phone:646-420-1464
Mailing Address - Fax:
Practice Address - Street 1:636 2ND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-2602
Practice Address - Country:US
Practice Address - Phone:646-420-1464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)