Provider Demographics
NPI:1740936095
Name:SIMELANE, HALE
Entity type:Individual
Prefix:
First Name:HALE
Middle Name:
Last Name:SIMELANE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 GILLOTTI RD
Mailing Address - Street 2:
Mailing Address - City:NEW FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06812-2561
Mailing Address - Country:US
Mailing Address - Phone:518-879-5096
Mailing Address - Fax:
Practice Address - Street 1:85 GILLOTTI RD
Practice Address - Street 2:
Practice Address - City:NEW FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06812-2561
Practice Address - Country:US
Practice Address - Phone:518-879-5096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist