Provider Demographics
NPI:1639605397
Name:SIMINGTON, NANCY (COTA)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:SIMINGTON
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 SCHOOL ST APT 1
Mailing Address - Street 2:
Mailing Address - City:KEESEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12944-1014
Mailing Address - Country:US
Mailing Address - Phone:631-601-5922
Mailing Address - Fax:
Practice Address - Street 1:46 SCHOOL ST APT 1
Practice Address - Street 2:
Practice Address - City:KEESEVILLE
Practice Address - State:NY
Practice Address - Zip Code:12944-1014
Practice Address - Country:US
Practice Address - Phone:631-601-5922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009298224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY009298OtherNYS LICENSE