Provider Demographics
NPI:1952945198
Name:SHIMKIN, ANTHONY (CRPA)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:
Last Name:SHIMKIN
Suffix:
Gender:M
Credentials:CRPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 W 143RD ST APT 2C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-5957
Mailing Address - Country:US
Mailing Address - Phone:646-408-9639
Mailing Address - Fax:
Practice Address - Street 1:275 NORTH ST.
Practice Address - Street 2:OARS
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528
Practice Address - Country:US
Practice Address - Phone:914-925-5261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-31
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCRPA-P-3866175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist