Provider Demographics
NPI:1356163877
Name:SIMONYANTS, DANIL N
Entity type:Individual
Prefix:
First Name:DANIL
Middle Name:N
Last Name:SIMONYANTS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 MANHATTAN AVE APT 1A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-3136
Mailing Address - Country:US
Mailing Address - Phone:305-515-0015
Mailing Address - Fax:
Practice Address - Street 1:67 MANHATTAN AVE APT 1A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-3136
Practice Address - Country:US
Practice Address - Phone:305-515-0015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLG116113164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse