Provider Demographics
NPI:1821329558
Name:DESIMONE, MAUREEN (RN)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:
Last Name:DESIMONE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 PARK LN
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:NY
Mailing Address - Zip Code:10589-3022
Mailing Address - Country:US
Mailing Address - Phone:914-592-7138
Mailing Address - Fax:914-592-0381
Practice Address - Street 1:95 BRADHURST AVENUE
Practice Address - Street 2:BLYTHEDALE CHILDREN'S HOSPITAL
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595
Practice Address - Country:US
Practice Address - Phone:914-592-7138
Practice Address - Fax:914-592-0381
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY281668163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse