Individual
CHAMNONG NIMNUAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.N.
Contact information
Practice address
9972 66TH RD, APT 5E, REGO PARK, NY 11374-4460
(646) 500-4255
Mailing address
9972 66TH RD, APT 5E, REGO PARK, NY 11374-4460
(646) 500-4255
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2966331
NY
Other
Enumeration date
06/07/2015
Last updated
06/07/2015
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