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NPI Code Detail

MEDICARE: JULIE SIMMONS O.D.

MEDICARE: JULIE SIMMONS O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOEG003079PA
2152W00000XOptometristOPC5734FL
3152W00000XOptometrist0618002679VA
4152W00000XOptometrist009273NY

General Provider Information

NPI Number : 1548645179
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE SIMMONS O.D.
Provider Business Mailing Address
First Line : 435 E 79TH ST APT 10V
Second Line :
City : NEW YORK
State : NY
Zip : 10075-1077
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 267 BROADWAY
Second Line :
City : BROOKLYN
State : NY
Zip : 11211-6216
Country : US
Telephone Number : 212-764-0008
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2015
Last Update Date : 05/12/2026

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