Shimrat R Notik, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

55533 Issued in CT

Practice address

999 Summer St
Ste 305
Stamford, CT 06905-5513

Phone

(203) 428-4440

Fax

(203) 890-9449

NPI assigned

Jun 19, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Shimrat R Yaniv Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1033472568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 SUMMER ST",
            "address_2": "STE 305",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055513",
            "telephone_number": "203-428-4440",
            "fax_number": "203-890-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 SUMMER ST",
            "address_2": "STE 305",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055513",
            "telephone_number": "203-428-4440",
            "fax_number": "203-890-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOTIK",
        "first_name": "SHIMRAT",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "55533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIMRAT",
            "last_name": "YANIV",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dermatology Physician in Stamford, CT
• Providers in Stamford, CT by specialty
• Dermatology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.