MEDICARE: DR. SIMONE AVRIL VILAIRE DC

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	111N00000X	Chiropractor	38MC00605100	NJ
2	111N00000X	Chiropractor	X010054	NY

General Provider Information

NPI Number	:	1164666756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SIMONE AVRIL VILAIRE DC

Provider Business Mailing Address
First Line	:	5 SAINT CHARLES PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11216-4108
Country	:	US
Telephone Number	:	917-456-2951
Fax Number	:

Provider Business Practice Location Address
First Line	:	690 BAY ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-3830
Country	:	US
Telephone Number	:	917-456-2951
Fax Number	:

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

Provider Enumeration Date	:	04/27/2009
Last Update Date	:	11/12/2014

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Directions to “ DR. SIMONE AVRIL VILAIRE DC” Practice Location

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