Provider Demographics
NPI:1831763614
Name:MATHUR, NIMISHA (MBBS)
Entity type:Individual
Prefix:MS
First Name:NIMISHA
Middle Name:
Last Name:MATHUR
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:B-5/403, LUNKAD COLONNADE-1, VIMAN NAGAR
Mailing Address - Street 2:
Mailing Address - City:PUNE
Mailing Address - State:MAHARASHTRA
Mailing Address - Zip Code:411014
Mailing Address - Country:IN
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4500 PARSONS BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-670-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program