Individual
CHARLES MIMKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
226 W 14TH ST, NEW YORK, NY 10011-7201
(212) 604-1800
Mailing address
226 W 14TH ST, NEW YORK, NY 10011-7201
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
297395
NY
Other
Enumeration date
04/18/2016
Last updated
11/17/2021
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