Provider Demographics
NPI:1629601133
Name:SIMON, KATALIN (LMT)
Entity Type:Individual
Prefix:
First Name:KATALIN
Middle Name:
Last Name:SIMON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 HARRIS RD APT KA5
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10507-2127
Mailing Address - Country:US
Mailing Address - Phone:914-602-4491
Mailing Address - Fax:
Practice Address - Street 1:5 N GREENWICH RD
Practice Address - Street 2:
Practice Address - City:ARMONK
Practice Address - State:NY
Practice Address - Zip Code:10504-2311
Practice Address - Country:US
Practice Address - Phone:914-202-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008167225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist