Provider Demographics
NPI:1255741708
Name:SIMIU, ERICA (PHD)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:SIMIU
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:SIMIU-HAVIV
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:227 MADISON ST
Mailing Address - Street 2:FIFTH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-7537
Mailing Address - Country:US
Mailing Address - Phone:917-628-3223
Mailing Address - Fax:
Practice Address - Street 1:227 MADISON ST
Practice Address - Street 2:FIFTH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-7537
Practice Address - Country:US
Practice Address - Phone:917-628-3223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-06
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020456103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist