Provider Demographics
NPI:1801283585
Name:BLIMAN KIMMEL, NAOMI
Entity type:Individual
Prefix:MRS
First Name:NAOMI
Middle Name:
Last Name:BLIMAN KIMMEL
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:NAOMI
Other - Middle Name:
Other - Last Name:BLIMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:145 W 67TH ST APT 29H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-5938
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:145 W 67TH ST APT 29H
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-5938
Practice Address - Country:US
Practice Address - Phone:646-528-7344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-21
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081013104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker