Provider Demographics
NPI:1922729300
Name:LEE, SIMONA RITA-MARIE (OT)
Entity Type:Individual
Prefix:
First Name:SIMONA
Middle Name:RITA-MARIE
Last Name:LEE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 5TH AVE APT 6L
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-3996
Mailing Address - Country:US
Mailing Address - Phone:914-499-1500
Mailing Address - Fax:914-478-8781
Practice Address - Street 1:1015 SAW MILL RIVER RD
Practice Address - Street 2:
Practice Address - City:ARDSLEY
Practice Address - State:NY
Practice Address - Zip Code:10502-1118
Practice Address - Country:US
Practice Address - Phone:914-400-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027045225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand