Individual
MR. SIMON D MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC
Contact information
Practice address
80TH ST & 41ST AVE, ELMHURST, NY 11373-1329
(718) 334-3900
(718) 334-5958
Mailing address
7901 BROADWAY, MANAGED CARE, D1-01, ELMHURST, NY 11373-1329
(718) 334-1921
(718) 334-3432
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
020578
NY
Other
Enumeration date
12/31/2007
Last updated
12/31/2007
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