Provider Demographics
NPI:1578823027
Name:SIMONE, SHEILA MARY (LPN)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:MARY
Last Name:SIMONE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PINEGROVE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:10560-3403
Mailing Address - Country:US
Mailing Address - Phone:914-276-2245
Mailing Address - Fax:
Practice Address - Street 1:2 PINEGROVE DR
Practice Address - Street 2:
Practice Address - City:NORTH SALEM
Practice Address - State:NY
Practice Address - Zip Code:10560-3403
Practice Address - Country:US
Practice Address - Phone:914-276-2245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY257262-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse