Healthcare Provider Details

I. General information

NPI: 1043760929
Provider Name (Legal Business Name): SIMONE ANDREWS PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2016
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 BROAD ST
NEW YORK NY
10004-2205
US

IV. Provider business mailing address

29 CRESCENT AVE
STATEN ISLAND NY
10301-1705
US

V. Phone/Fax

Practice location:
  • Phone: 646-450-9431
  • Fax: 212-898-0131
Mailing address:
  • Phone: 646-450-9431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number68021603
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: