Provider Demographics
NPI:1467638585
Name:SIMEON, FRANTZ JUNIOR
Entity Type:Individual
Prefix:
First Name:FRANTZ
Middle Name:JUNIOR
Last Name:SIMEON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:699 LINDEN BLVD # 3A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-3314
Mailing Address - Country:US
Mailing Address - Phone:646-206-6309
Mailing Address - Fax:
Practice Address - Street 1:701 LINDEN BLVD APT 3A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-3324
Practice Address - Country:US
Practice Address - Phone:646-206-6309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY63014822251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services