Provider Demographics
NPI:1336394816
Name:SIMAKOVSKY, LEONID (DC)
Entity Type:Individual
Prefix:MR
First Name:LEONID
Middle Name:
Last Name:SIMAKOVSKY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1653 W 7TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-1379
Mailing Address - Country:US
Mailing Address - Phone:646-541-2141
Mailing Address - Fax:
Practice Address - Street 1:8120 15TH AVENUE, LL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228
Practice Address - Country:US
Practice Address - Phone:718-236-1050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008486111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor