Provider Demographics
NPI:1699109025
Name:THAKKER, RIMA (OD)
Entity type:Individual
Prefix:MS
First Name:RIMA
Middle Name:
Last Name:THAKKER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 5TH AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10176-0001
Mailing Address - Country:US
Mailing Address - Phone:212-719-4000
Mailing Address - Fax:646-759-3565
Practice Address - Street 1:551 5TH AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10176-0001
Practice Address - Country:US
Practice Address - Phone:212-719-4000
Practice Address - Fax:646-759-3565
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ270A00646900152W00000X
NY008073152W00000X
AZ1988152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist