Individual
DOROTHEA ANNA SIMONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
350 APPLEGATE RD N, R-6, ITHACA, NY 14850-9226
(607) 273-0279
Mailing address
350 APPLEGATE RD N, R-6, ITHACA, NY 14850-9226
(607) 273-0279
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
295084-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01923591
—
NY
Enumeration date
06/25/2007
Last updated
07/09/2007
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