Provider Demographics
NPI:1346542974
Name:SIMEONIDIS-ATTARD, ROSAMOND JOANNA (MA CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ROSAMOND
Middle Name:JOANNA
Last Name:SIMEONIDIS-ATTARD
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:MS
Other - First Name:ROSAMOND
Other - Middle Name:JOANNA
Other - Last Name:SIMEONIDIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:2257 24TH ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-3412
Mailing Address - Country:US
Mailing Address - Phone:646-662-0145
Mailing Address - Fax:646-383-9290
Practice Address - Street 1:2257 24TH ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-3412
Practice Address - Country:US
Practice Address - Phone:646-662-0145
Practice Address - Fax:646-383-9290
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019067-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist