Healthcare Provider Details

I. General information

NPI: 1316826472
Provider Name (Legal Business Name): SIMA TVERSKY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2025
Last Update Date: 09/01/2025
Certification Date: 09/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6210 15TH AVE
BROOKLYN NY
11219-5403
US

IV. Provider business mailing address

975 E 14TH ST
BROOKLYN NY
11230-3611
US

V. Phone/Fax

Practice location:
  • Phone: 718-303-9400
  • Fax:
Mailing address:
  • Phone: 917-620-5939
  • Fax: 917-620-5939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number897865-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: