Provider Demographics
NPI:1164692521
Name:SIMONE EUDOVIC
Entity Type:Organization
Organization Name:SIMONE EUDOVIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMONE
Authorized Official - Middle Name:E
Authorized Official - Last Name:EUDOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:914-361-1818
Mailing Address - Street 1:623 WARBURTON AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HASTINGS ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10706-1523
Mailing Address - Country:US
Mailing Address - Phone:914-361-1818
Mailing Address - Fax:
Practice Address - Street 1:623 WARBURTON AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10706-1523
Practice Address - Country:US
Practice Address - Phone:914-361-1818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-01
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025616261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy