Basic Information
| Provider Information | |||||||||
| NPI: | 1487940987 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AMELIO-SIMULCIK | ||||||||
| FirstName: | NINA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 480 | ||||||||
| Address2: | |||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939020480 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8316243579 | ||||||||
| FaxNumber: | 8316243615 | ||||||||
| Practice Location | |||||||||
| Address1: | 259 1ST ST | ||||||||
| Address2: | |||||||||
| City: | MINEOLA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115013957 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166633010 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2011 | ||||||||
| LastUpdateDate: | 08/09/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 20A14303 | CA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.