Provider Demographics
NPI:1104531821
Name:NISHIMURA, NORIKO (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:NORIKO
Middle Name:
Last Name:NISHIMURA
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:NORIKO
Other - Middle Name:
Other - Last Name:YOSHITAKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:530 E 74TH ST # 21163D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3459
Mailing Address - Country:US
Mailing Address - Phone:646-608-2721
Mailing Address - Fax:
Practice Address - Street 1:530 E 74TH ST # 21163D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-3459
Practice Address - Country:US
Practice Address - Phone:646-608-2721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY320032207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology