Provider Demographics
NPI:1851977193
Name:NOVA ANTOINETTE SIMISTER-IRVING LCSW PC
Entity Type:Organization
Organization Name:NOVA ANTOINETTE SIMISTER-IRVING LCSW PC
Other - Org Name:NOVA SIMISTER LCSW, P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NOVA
Authorized Official - Middle Name:ANTOINETTE
Authorized Official - Last Name:SIMISTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:914-316-1914
Mailing Address - Street 1:PO BOX 351
Mailing Address - Street 2:
Mailing Address - City:POUGHQUAG
Mailing Address - State:NY
Mailing Address - Zip Code:12570-0351
Mailing Address - Country:US
Mailing Address - Phone:914-316-1914
Mailing Address - Fax:
Practice Address - Street 1:730 E 232ND ST APT 3A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-4115
Practice Address - Country:US
Practice Address - Phone:914-316-1914
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-18
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1346679198OtherTIN