Provider Demographics
NPI:1013096577
Name:CINQUE, SIMONE MEMANIYE (CNM)
Entity Type:Individual
Prefix:MS
First Name:SIMONE
Middle Name:MEMANIYE
Last Name:CINQUE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 HALSEY ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-1014
Mailing Address - Country:US
Mailing Address - Phone:718-573-2432
Mailing Address - Fax:718-554-0572
Practice Address - Street 1:409 HALSEY ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-1014
Practice Address - Country:US
Practice Address - Phone:718-573-2432
Practice Address - Fax:718-554-0572
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF360431-1363LX0001X
NYF000801-1367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Not Answered367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02153042Medicaid