Healthcare Provider Details

I. General information

NPI: 1629601133
Provider Name (Legal Business Name): KATALIN SIMON LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2020
Last Update Date: 02/13/2020
Certification Date: 02/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 N GREENWICH RD
ARMONK NY
10504-2311
US

IV. Provider business mailing address

208 HARRIS RD APT KA5
BEDFORD HILLS NY
10507-2127
US

V. Phone/Fax

Practice location:
  • Phone: 914-202-0700
  • Fax:
Mailing address:
  • Phone: 914-602-4491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number008167
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: