Provider Demographics
NPI:1871746818
Name:CHIMA, GEORGINA
Entity type:Individual
Prefix:
First Name:GEORGINA
Middle Name:
Last Name:CHIMA
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 1:2630 KINGSBRIDGE TER
Mailing Address - Street 2:APT 1-W
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-7503
Mailing Address - Country:US
Mailing Address - Phone:718-584-5364
Mailing Address - Fax:
Practice Address - Street 1:2630 KINGSBRIDGE TER
Practice Address - Street 2:APT 1-W
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-7503
Practice Address - Country:US
Practice Address - Phone:718-584-5364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251234164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse