Provider Demographics
NPI:1558625095
Name:SIMPSON, HORTENSIA
Entity Type:Individual
Prefix:MRS
First Name:HORTENSIA
Middle Name:
Last Name:SIMPSON
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 1:1100 CONEY ISLAND AVE
Mailing Address - Street 2:414
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-2344
Mailing Address - Country:US
Mailing Address - Phone:718-434-1012
Mailing Address - Fax:718-434-1088
Practice Address - Street 1:1100 CONEY ISLAND AVE
Practice Address - Street 2:414
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-2344
Practice Address - Country:US
Practice Address - Phone:718-434-1012
Practice Address - Fax:718-434-1088
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY16151171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator