Provider Demographics
NPI:1235492687
Name:SIMANCAS, NORMA PATRICIA
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:PATRICIA
Last Name:SIMANCAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3636 33RD ST
Mailing Address - Street 2:500
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11106-2329
Mailing Address - Country:US
Mailing Address - Phone:212-589-1224
Mailing Address - Fax:212-529-1430
Practice Address - Street 1:3636 33RD ST
Practice Address - Street 2:500
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11106-2329
Practice Address - Country:US
Practice Address - Phone:212-589-1224
Practice Address - Fax:212-529-1430
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
NY093419104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator