Provider Demographics
NPI:1184100455
Name:CAI, SIMON CINYEH (PTA)
Entity type:Individual
Prefix:MR
First Name:SIMON
Middle Name:CINYEH
Last Name:CAI
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:MR
Other - First Name:CINYEH
Other - Middle Name:
Other - Last Name:CAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:414 W 121ST ST APT 33
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-6004
Mailing Address - Country:US
Mailing Address - Phone:646-784-7378
Mailing Address - Fax:
Practice Address - Street 1:4277 65TH PL
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-5054
Practice Address - Country:US
Practice Address - Phone:718-429-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant