Healthcare Provider Details

I. General information

NPI: 1033039318
Provider Name (Legal Business Name): JULIE K SIMONSON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4604 SKILLMAN AVE
SUNNYSIDE NY
11104-2119
US

IV. Provider business mailing address

3933 47TH ST
SUNNYSIDE NY
11104-1419
US

V. Phone/Fax

Practice location:
  • Phone: 718-208-6842
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number045855
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: