Provider Demographics
NPI:1760236509
Name:SIMBANA CRIOLLO, ARIEL RENATO
Entity Type:Individual
Prefix:MR
First Name:ARIEL
Middle Name:RENATO
Last Name:SIMBANA CRIOLLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30435 MOUNT VERNON RD
Mailing Address - Street 2:
Mailing Address - City:PRINCESS ANNE
Mailing Address - State:MD
Mailing Address - Zip Code:21853-1437
Mailing Address - Country:US
Mailing Address - Phone:410-205-5132
Mailing Address - Fax:
Practice Address - Street 1:30435 MOUNT VERNON RD
Practice Address - Street 2:
Practice Address - City:PRINCESS ANNE
Practice Address - State:MD
Practice Address - Zip Code:21853-1437
Practice Address - Country:US
Practice Address - Phone:410-205-5132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker