MEDICARE: DR. SIMONA LUMERMAN PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	014320-1	NY

General Provider Information

NPI Number	:	1124209689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SIMONA LUMERMAN PSY.D.

Provider Business Mailing Address
First Line	:	123 GROVE AVE
Second Line	:	SUITE #202
City	:	CEDARHURST
State	:	NY
Zip	:	11516-2322
Country	:	US
Telephone Number	:	516-569-0568
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 GROVE AVENUE
Second Line	:	SUITE #202
City	:	CEDARHURST
State	:	NY
Zip	:	11516-2322
Country	:	US
Telephone Number	:	516-569-0568
Fax Number	:	516-792-1234

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/26/2007
Last Update Date	:	12/09/2008

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