Provider Demographics
NPI:1578263901
Name:SIMANSKI, THOMAS (DNP)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:SIMANSKI
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1048 GREEN HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH ABINGTON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18411-9460
Mailing Address - Country:US
Mailing Address - Phone:952-237-1310
Mailing Address - Fax:
Practice Address - Street 1:1 STORM ST
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-2406
Practice Address - Country:US
Practice Address - Phone:570-421-4978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN730574367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered