Provider Demographics
NPI:1780954529
Name:SIMONS, DANA MARISA (RN)
Entity type:Individual
Prefix:MS
First Name:DANA
Middle Name:MARISA
Last Name:SIMONS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 DAVIS ST
Mailing Address - Street 2:
Mailing Address - City:LOCUST VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:11560-1808
Mailing Address - Country:US
Mailing Address - Phone:516-661-2565
Mailing Address - Fax:
Practice Address - Street 1:16 DAVIS ST
Practice Address - Street 2:
Practice Address - City:LOCUST VALLEY
Practice Address - State:NY
Practice Address - Zip Code:11560-1808
Practice Address - Country:US
Practice Address - Phone:516-661-2565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY647762163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse