Provider Demographics
NPI:1245338029
Name:SHNAYDMAN, RIMMA (DO MD)
Entity type:Individual
Prefix:
First Name:RIMMA
Middle Name:
Last Name:SHNAYDMAN
Suffix:
Gender:F
Credentials:DO MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:396 AVENUE X
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-6008
Mailing Address - Country:US
Mailing Address - Phone:718-376-6500
Mailing Address - Fax:718-376-5078
Practice Address - Street 1:396 AVENUE X
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-6008
Practice Address - Country:US
Practice Address - Phone:718-336-4499
Practice Address - Fax:718-336-2013
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205670207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01818111Medicaid
NYG67831Medicare UPIN
NY05V011Medicare PIN