Healthcare Provider Details

I. General information

NPI: 1609704238
Provider Name (Legal Business Name): SIMA SHLEYMOVICH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9046 CORONA AVE
ELMHURST NY
11373-4076
US

IV. Provider business mailing address

9516 161ST AVE
HOWARD BEACH NY
11414-3825
US

V. Phone/Fax

Practice location:
  • Phone: 347-229-9167
  • Fax:
Mailing address:
  • Phone: 347-216-3396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number346333
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: