Individual
CHARLES P KIMMELMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
993 PARK AVE, STE 1C, NEW YORK, NY 10028-0809
(212) 717-7262
(212) 717-1307
Mailing address
993 PARK AVE, STE 1C, NEW YORK, NY 10028-0809
(212) 717-7262
(212) 717-1307
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
165440
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
165440
NYS LICENSE
NY
01
—
63D721
PTAN
NY
Enumeration date
12/09/2006
Last updated
07/05/2012
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