Provider Demographics
NPI:1215284138
Name:SUTTON, RIMMA
Entity type:Individual
Prefix:
First Name:RIMMA
Middle Name:
Last Name:SUTTON
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 1:3110 QUEENS BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-3002
Mailing Address - Country:US
Mailing Address - Phone:718-593-4121
Mailing Address - Fax:
Practice Address - Street 1:3110 QUEENS BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-3002
Practice Address - Country:US
Practice Address - Phone:718-593-4121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program