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Individual
DEENA A KIMIATEK
Active
Individual
DEENA A KIMIATEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
040110-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619908
BCBS IL GROUP NUMBER
IL
01
—
1623066
BCBS IL PROVIDER #
IL
01
—
200852
MEDICARE GROUP #
IL
01
—
202542
MEDICARE GROUP #
IL
01
—
367885100
U.S. DEPT. OF LABOR
IL
01
—
567700
MEDICARE GROUP NUMBER
IL
01
—
568080
MEDICARE GROUP NUMBER
IL
01
—
568150
MEDICARE GROUP NUMBER
IL
Enumeration date
05/27/2006
Last updated
12/03/2020
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