Provider Demographics
NPI:1861715740
Name:GAMER, RIMMA
Entity type:Individual
Prefix:
First Name:RIMMA
Middle Name:
Last Name:GAMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2505
Mailing Address - Country:US
Mailing Address - Phone:718-743-5919
Mailing Address - Fax:
Practice Address - Street 1:6725 BAY PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-4735
Practice Address - Country:US
Practice Address - Phone:718-837-0600
Practice Address - Fax:718-837-0140
Is Sole Proprietor?:No
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047330183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist