Healthcare Provider Details

I. General information

NPI: 1013096577
Provider Name (Legal Business Name): SIMONE MEMANIYE CINQUE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 HALSEY ST
BROOKLYN NY
11233-1014
US

IV. Provider business mailing address

409 HALSEY ST
BROOKLYN NY
11233-1014
US

V. Phone/Fax

Practice location:
  • Phone: 718-573-2432
  • Fax: 718-554-0572
Mailing address:
  • Phone: 718-573-2432
  • Fax: 718-554-0572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberF360431-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberF000801-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: