Provider Demographics
NPI:1902227051
Name:SIMAK, NATALIYA
Entity Type:Individual
Prefix:
First Name:NATALIYA
Middle Name:
Last Name:SIMAK
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 1:3201 ROBIN HOOD CT
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-2361
Mailing Address - Country:US
Mailing Address - Phone:443-474-4122
Mailing Address - Fax:
Practice Address - Street 1:5570 STERRETT PL STE 308
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2654
Practice Address - Country:US
Practice Address - Phone:443-474-4122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01938171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist