Individual
MS. STACEY ELIZABETH SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
480 BEDFORD RD STE 3201, CHAPPAQUA, NY 10514-1726
(603) 264-7382
Mailing address
98 DEERFIELD LN N, PLEASANTVILLE, NY 10570-1406
(603) 264-7382
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86007711
NY
133V00000X
Registered Dietitian
DT88058
TX
133VN1101X
Gerontological Nutrition Registered Dietitian
86007711
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86007711
REGISTERED DIETITIAN
—
Enumeration date
01/08/2014
Last updated
03/19/2026
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