Provider Demographics
NPI:1801905583
Name:NAIM, ANTOINE A (MD)
Entity type:Individual
Prefix:DR
First Name:ANTOINE
Middle Name:A
Last Name:NAIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:TONY
Other - Middle Name:
Other - Last Name:NAIM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:521 MT PLEASANT DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18503-1993
Mailing Address - Country:US
Mailing Address - Phone:570-346-7338
Mailing Address - Fax:570-341-3025
Practice Address - Street 1:521 MT PLEASANT DR STE 101
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1993
Practice Address - Country:US
Practice Address - Phone:570-346-7338
Practice Address - Fax:570-341-3025
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD045657L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPENDINGMedicaid
4179051Medicare ID - Type Unspecified
PAPENDINGMedicaid
WVNA7364981Medicare PIN
WVNA7364981Medicare PIN