Provider Demographics
NPI:1689559791
Name:LIM, DABIN NICOLE
Entity type:Individual
Prefix:
First Name:DABIN
Middle Name:NICOLE
Last Name:LIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2158 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-4223
Mailing Address - Country:US
Mailing Address - Phone:516-387-5024
Mailing Address - Fax:
Practice Address - Street 1:2158 WILLOW ST
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-4223
Practice Address - Country:US
Practice Address - Phone:516-387-5024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program