Provider Demographics
NPI:1437491412
Name:SIMONS, ALEZA HANDELMAN
Entity Type:Individual
Prefix:MRS
First Name:ALEZA
Middle Name:HANDELMAN
Last Name:SIMONS
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 1:111 COBB ST
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-4907
Mailing Address - Country:US
Mailing Address - Phone:607-273-2575
Mailing Address - Fax:
Practice Address - Street 1:111 COBB ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-4907
Practice Address - Country:US
Practice Address - Phone:607-273-2575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist