Provider Demographics
NPI:1356694988
Name:TYMINSKI, MONIKA (RN)
Entity type:Individual
Prefix:
First Name:MONIKA
Middle Name:
Last Name:TYMINSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FLORIDA
Mailing Address - State:NY
Mailing Address - Zip Code:10921-1304
Mailing Address - Country:US
Mailing Address - Phone:845-239-5509
Mailing Address - Fax:
Practice Address - Street 1:30 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:FLORIDA
Practice Address - State:NY
Practice Address - Zip Code:10921-1304
Practice Address - Country:US
Practice Address - Phone:845-239-5509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY663748163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health