Provider Demographics
NPI:1871972042
Name:NSUH OB-GYN ASSOCIATES
Entity type:Organization
Organization Name:NSUH OB-GYN ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:NIMAROFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-472-5700
Mailing Address - Street 1:600 NORTHERN BLVD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5206
Mailing Address - Country:US
Mailing Address - Phone:516-472-5700
Mailing Address - Fax:
Practice Address - Street 1:600 NORTHERN BLVD
Practice Address - Street 2:SUITE 212
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5206
Practice Address - Country:US
Practice Address - Phone:516-472-5700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-21
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY401833-1261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty