Provider Demographics
NPI:1790584316
Name:SIMMERER, BRADLEY ALAN
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:ALAN
Last Name:SIMMERER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6272 VIA FLORENZA DR
Mailing Address - Street 2:
Mailing Address - City:GALENA
Mailing Address - State:OH
Mailing Address - Zip Code:43021-7627
Mailing Address - Country:US
Mailing Address - Phone:330-421-9376
Mailing Address - Fax:
Practice Address - Street 1:6272 VIA FLORENZA DR
Practice Address - Street 2:
Practice Address - City:GALENA
Practice Address - State:OH
Practice Address - Zip Code:43021-7627
Practice Address - Country:US
Practice Address - Phone:330-421-9376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-08
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker