Provider Demographics
NPI:1063519304
Name:RIMAWI, HUSAM K (MD)
Entity type:Individual
Prefix:DR
First Name:HUSAM
Middle Name:K
Last Name:RIMAWI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6317 4TH AVE
Mailing Address - Street 2:PARK RIDGE FAMILY HEALTH
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-4922
Mailing Address - Country:US
Mailing Address - Phone:718-907-8100
Mailing Address - Fax:718-492-8614
Practice Address - Street 1:6317 4TH AVE
Practice Address - Street 2:PARK RIDGE FAMILY HEALTH
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4922
Practice Address - Country:US
Practice Address - Phone:718-907-8100
Practice Address - Fax:718-492-8614
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY142234207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00585855Medicaid
NY49A141Medicare ID - Type Unspecified
NY00585855Medicaid