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NPI Code Detail

MEDICARE: ANGELA SIMON

MEDICARE: ANGELA SIMON
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
1171100000XAcupuncturist007611--01NY

General Provider Information

NPI Number : 1578372736
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA SIMON
Provider Business Mailing Address
First Line : 208 HULL ST APT C
Second Line :
City : BROOKLYN
State : NY
Zip : 11233-2931
Country : US
Telephone Number : 917-922-4366
Fax Number :
Provider Business Practice Location Address
First Line : 181 LEXINGTON AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11216-6446
Country : US
Telephone Number : 862-252-1230
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2025
Last Update Date : 01/02/2025

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