Provider Demographics
NPI:1932362969
Name:FIMINSKI, MARY ANN (RN)
Entity Type:Individual
Prefix:MISS
First Name:MARY ANN
Middle Name:
Last Name:FIMINSKI
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 1:107 NOTT TER STE 304
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-3170
Mailing Address - Country:US
Mailing Address - Phone:518-386-2824
Mailing Address - Fax:518-382-5418
Practice Address - Street 1:107 NOTT TER STE 304
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-3170
Practice Address - Country:US
Practice Address - Phone:518-386-2824
Practice Address - Fax:518-382-5418
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY339083-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse