Individual
MS. PAMELA D SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1234 E 83RD ST # 1, BROOKLYN, NY 11236-4933
(718) 209-5465
Mailing address
1234 E 83RD ST # 1, BROOKLYN, NY 11236-4933
(718) 209-5465
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
870734
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
UNKNOWN
UNKNOWN
—
Enumeration date
06/08/2022
Last updated
06/08/2022
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