Provider Demographics
NPI:1740364975
Name:SIMS, PAULA (MD)
Entity type:Individual
Prefix:DR
First Name:PAULA
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 CIMARRON RD
Mailing Address - Street 2:
Mailing Address - City:PUTNAM VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10579-1807
Mailing Address - Country:US
Mailing Address - Phone:914-548-2891
Mailing Address - Fax:
Practice Address - Street 1:21 CIMARRON RD
Practice Address - Street 2:
Practice Address - City:PUTNAM VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10579-1807
Practice Address - Country:US
Practice Address - Phone:914-548-2891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY149811208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01227678Medicaid
NY71F312Medicare ID - Type Unspecified
NYE74692Medicare UPIN