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General NPI Number Information
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NPI Number | 1548783939
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Entity Type | Individual
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Provider Name | SOTIRIA SIMEONIDIS PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/18/2017
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Last Update Date | 11/01/2025
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Provider Practice Location Address
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Address Line | 55 PALMER AVE
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City | BRONXVILLE
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State | NY
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Zip | 10708-3403
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Country | US
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Telephone | 914-787-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 32 JEFFERSON ST
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City | NUTLEY
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State | NJ
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Zip | 07110-3122
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 020987
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License Number State | NY
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