Provider Demographics
NPI:1649376575
Name:RIMMER, LINDA MARIE (NP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:RIMMER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 W 49TH ST STE 405
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-7431
Mailing Address - Country:US
Mailing Address - Phone:212-651-8120
Mailing Address - Fax:888-345-0265
Practice Address - Street 1:250 W 49TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-7400
Practice Address - Country:US
Practice Address - Phone:212-651-8120
Practice Address - Fax:888-345-0265
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2013-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302901363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00310361Medicaid
NY00310361Medicaid
NYRA2464Medicare ID - Type UnspecifiedUPSTATE MEDICARE