Provider Demographics
NPI:1528294964
Name:FENTON-KERIMIAN, MARIA B (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:B
Last Name:FENTON-KERIMIAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
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Mailing Address - Street 1:160 EAST 34TH STREET
Mailing Address - Street 2:LL-144
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-731-5035
Mailing Address - Fax:212-731-5516
Practice Address - Street 1:160 E 34TH ST
Practice Address - Street 2:LL-144
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4744
Practice Address - Country:US
Practice Address - Phone:212-731-5035
Practice Address - Fax:212-731-5516
Is Sole Proprietor?:No
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY303783363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health