MEDICARE: ELIZABETH PAPA SIMONS DPT

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	225100000X	Physical Therapist	1-033233	NY

General Provider Information

NPI Number	:	1518268333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH PAPA SIMONS DPT

Provider Business Mailing Address
First Line	:	38 BEACHWAY
Second Line	:
City	:	PORT WASHINGTON
State	:	NY
Zip	:	11050-3408
Country	:	US
Telephone Number	:	516-319-0502
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 ROOSEVELT AVENUE
Second Line	:	FL 1
City	:	ROSLYN
State	:	NY
Zip	:	11576-1105
Country	:	US
Telephone Number	:	516-319-0502
Fax Number	:

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

Provider Enumeration Date	:	11/10/2010
Last Update Date	:	02/08/2024

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