MR. John Ricardo Jimenez

NPI #1982965059 in Central Islip, New York

Provider Information

NPI Number: 1982965059
Entity Type: Individual
Name: MR. John Ricardo Jimenez
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Jun 5, 2012
Last Updated: Jun 5, 2012

Practice Location

Address: 83 PINEWOOD AVE
City: Central Islip
State: New York
ZIP Code: 11722-3213
Phone: (631) 761-6029

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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