Healthcare Provider Details

I. General information

NPI: 1386078558
Provider Name (Legal Business Name): YRLANDE SIMON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2013
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1018 BROAD ST STE 8
BLOOMFIELD NJ
07003-2884
US

IV. Provider business mailing address

68 WILLOW ST
BLOOMFIELD NJ
07003-3216
US

V. Phone/Fax

Practice location:
  • Phone: 973-392-2864
  • Fax:
Mailing address:
  • Phone: 973-392-2864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ00450400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: