Provider Demographics
NPI:1881962017
Name:ROBERT V SIMEONE DC PC
Entity type:Organization
Organization Name:ROBERT V SIMEONE DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:SIMEONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-494-0615
Mailing Address - Street 1:456 ARLENE ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-3814
Mailing Address - Country:US
Mailing Address - Phone:718-494-0675
Mailing Address - Fax:
Practice Address - Street 1:456 ARLENE ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3814
Practice Address - Country:US
Practice Address - Phone:718-494-0675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-02
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty