Provider Demographics
NPI:1073250957
Name:ADULT HEALTH NP NYC PC
Entity Type:Organization
Organization Name:ADULT HEALTH NP NYC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOISEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMKHAYEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-406-7805
Mailing Address - Street 1:9930 64TH RD
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2646
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4047 95TH ST APT B
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1715
Practice Address - Country:US
Practice Address - Phone:646-559-6699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-12
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty