Healthcare Provider Details

I. General information

NPI: 1861796500
Provider Name (Legal Business Name): SIMONE ALLEN MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2011
Last Update Date: 07/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 NATHAN D PERLMAN PL
NEW YORK NY
10003-3851
US

IV. Provider business mailing address

10 NATHAN D PERLMAN PL
NEW YORK NY
10003-3851
US

V. Phone/Fax

Practice location:
  • Phone: 646-342-9888
  • Fax:
Mailing address:
  • Phone: 646-342-9888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number63016867
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number63016867
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: