Provider Demographics
NPI:1790816692
Name:ANZALONE SIMMONS, ROSEMARY
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:ANZALONE SIMMONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 OLD MAMARONECK RD
Mailing Address - Street 2:APARTMENT NO. 1A1
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-2441
Mailing Address - Country:US
Mailing Address - Phone:914-949-8019
Mailing Address - Fax:
Practice Address - Street 1:141 E 88TH ST
Practice Address - Street 2:SUITE # 2I
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-2273
Practice Address - Country:US
Practice Address - Phone:914-949-8019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000148-1102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst