Healthcare Provider Details

I. General information

NPI: 1588588651
Provider Name (Legal Business Name): DEANNA DESIMONE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1126 JAMES AVE
NIAGARA FALLS NY
14305-1130
US

IV. Provider business mailing address

1126 JAMES AVE
NIAGARA FALLS NY
14305-1130
US

V. Phone/Fax

Practice location:
  • Phone: 716-531-3805
  • Fax: 716-531-3805
Mailing address:
  • Phone: 716-531-3805
  • Fax: 716-531-3805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: DEANNA DESIMONE
Title or Position: OWNER/ SERVICE COORDINATOR
Credential:
Phone: 716-531-3805