Individual
COURTNEY ANTHONY SIMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13418 160TH ST, JAMAICA, NY 11434-3724
(917) 513-4791
Mailing address
13418 160TH ST, JAMAICA, NY 11434-3724
(917) 513-4791
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
229824-1
NY
Other
Enumeration date
10/10/2014
Last updated
10/10/2014
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