Provider Demographics
NPI:1609183086
Name:SIMON, GOLDIE (SLP)
Entity Type:Individual
Prefix:MS
First Name:GOLDIE
Middle Name:
Last Name:SIMON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MRS
Other - First Name:GOLDIE
Other - Middle Name:
Other - Last Name:ADLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SLP
Mailing Address - Street 1:2064 E 35TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4922
Mailing Address - Country:US
Mailing Address - Phone:347-713-5113
Mailing Address - Fax:
Practice Address - Street 1:2064 E 35TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4922
Practice Address - Country:US
Practice Address - Phone:347-713-5113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist