Provider Demographics
NPI:1851652614
Name:LOMAX, SIMONE (NP)
Entity Type:Individual
Prefix:
First Name:SIMONE
Middle Name:
Last Name:LOMAX
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11936 190TH ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11412-3621
Mailing Address - Country:US
Mailing Address - Phone:347-731-2911
Mailing Address - Fax:
Practice Address - Street 1:2054 TILLOTSON AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-1560
Practice Address - Country:US
Practice Address - Phone:718-671-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY654335163W00000X
NY421320363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse