Provider Demographics
NPI:1851958979
Name:SIMON, SHARON SIMONE (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:SIMONE
Last Name:SIMON
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 MIDWOOD ST
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-1504
Mailing Address - Country:US
Mailing Address - Phone:718-593-6402
Mailing Address - Fax:
Practice Address - Street 1:450 MIDWOOD ST
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-1504
Practice Address - Country:US
Practice Address - Phone:718-593-6402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY495736163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse