Healthcare Provider Details

I. General information

NPI: 1578097358
Provider Name (Legal Business Name): LYDIA MONTEIRO-SIMMONS DNP, NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2017
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 EASTCHESTER RD
BRONX NY
10461-2301
US

IV. Provider business mailing address

8-06 CHESTER ST
FAIR LAWN NJ
07410-1547
US

V. Phone/Fax

Practice location:
  • Phone: 718-904-4032
  • Fax:
Mailing address:
  • Phone: 201-446-3569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number26NJ00880500
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number350397
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: