Individual
CARLY NIMMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2 NICHOLAS CT, BETHPAGE, NY 11714-4616
(516) 993-5440
Mailing address
2 NICHOLAS CT, BETHPAGE, NY 11714-4616
(516) 993-5440
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
03/04/2019
Last updated
03/04/2019
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