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Individual

LAURA B NIMKOFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1000 MONTAUK HWY, WEST ISLIP, NY 11795-4927
(631) 376-3000
(631) 244-8560
Mailing address
1000 MONTAUK HWY, WEST ISLIP, NY 11795-4927
(631) 376-3000
(631) 244-8560

Taxonomy

Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
171491
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01506629
NY
01
170Y61
BLUE CROSS BLUE SHIELD
NY
Enumeration date
06/22/2005
Last updated
01/30/2008
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