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General NPI Number Information
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NPI Number | 1659510709
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Entity Type | Individual
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Provider Name | DEBORA SIMCHA SEMEL M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/12/2009
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Last Update Date | 12/14/2021
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Provider Practice Location Address
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Address Line | 26508 74TH AVE APT F1
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City | GLEN OAKS
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State | NY
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Zip | 11004-1167
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Country | US
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Telephone | 516-627-3542
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Fax | 516-627-3542
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Provider Business Mailing Address
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Address Line | 26508 74TH AVE APT F1
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City | GLEN OAKS
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State | NY
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Zip | 11004-1167
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Country | US
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Telephone | 516-627-3542
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Fax | 516-627-3542
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 249389-1
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License Number State | NY
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