Provider Demographics
NPI:1316726862
Name:CIMAFRANCA, NICOLE ESCALONA
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:ESCALONA
Last Name:CIMAFRANCA
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 1:140 FRANKLIN AVE APT 3A
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-2968
Mailing Address - Country:US
Mailing Address - Phone:862-213-6102
Mailing Address - Fax:
Practice Address - Street 1:80 MAIDEN LN RM 1007
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4764
Practice Address - Country:US
Practice Address - Phone:212-386-7812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051161-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist