Provider Demographics
NPI:1902415953
Name:NARULA, SIMMI S
Entity Type:Individual
Prefix:MRS
First Name:SIMMI
Middle Name:S
Last Name:NARULA
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 1:375 ISINGLASS RD
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-5708
Mailing Address - Country:US
Mailing Address - Phone:203-641-1834
Mailing Address - Fax:
Practice Address - Street 1:1200 HIGH RIDGE RD
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-1223
Practice Address - Country:US
Practice Address - Phone:203-641-1834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-27
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT109095163WP0808X
CT9208251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health