Provider Demographics
NPI:1790567741
Name:SIMMONDS, GARRETTE ADRIAN
Entity Type:Individual
Prefix:MR
First Name:GARRETTE
Middle Name:ADRIAN
Last Name:SIMMONDS
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 1:4376 163RD ST APT 4D
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-3267
Mailing Address - Country:US
Mailing Address - Phone:917-500-7310
Mailing Address - Fax:
Practice Address - Street 1:4376 163RD ST APT 4D
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-3267
Practice Address - Country:US
Practice Address - Phone:917-500-7310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY811995-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse