Provider Demographics
NPI:1760133995
Name:SIMMONS, SILVANA MICHELLE (MPA)
Entity Type:Individual
Prefix:MRS
First Name:SILVANA
Middle Name:MICHELLE
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 ARNOLD ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-2206
Mailing Address - Country:US
Mailing Address - Phone:347-216-3296
Mailing Address - Fax:
Practice Address - Street 1:59 ARNOLD ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-2206
Practice Address - Country:US
Practice Address - Phone:347-216-3296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator