Basic Information
Provider Information
NPI: 1447415401
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NIMES-MAYES
FirstName: OFELIA
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1450 MADISON AVE
Address2: 6TH FLOOR- ELECTROPHYSIOLOGY SERVICE
City: NEW YORK
State: NY
PostalCode: 100296508
CountryCode: US
TelephoneNumber: 2122413559
FaxNumber: 2125343776
Practice Location
Address1: 1450 MADISON AVE
Address2: 6TH FLOOR- ELECTROPHYSIOLOGY SERVICE
City: NEW YORK
State: NY
PostalCode: 100296508
CountryCode: US
TelephoneNumber: 2122413559
FaxNumber: 2125342776
Other Information
ProviderEnumerationDate: 07/18/2008
LastUpdateDate: 02/24/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200X302053NYY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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