Basic Information
| Provider Information | |||||||||
| NPI: | 1922729300 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEE | ||||||||
| FirstName: | SIMONA | ||||||||
| MiddleName: | RITA-MARIE | ||||||||
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| Credential: | OT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1255 5TH AVE APT 6L | ||||||||
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| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100293996 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144991500 | ||||||||
| FaxNumber: | 9144788781 | ||||||||
| Practice Location | |||||||||
| Address1: | 1015 SAW MILL RIVER RD | ||||||||
| Address2: | |||||||||
| City: | ARDSLEY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105021118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144001500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/06/2022 | ||||||||
| LastUpdateDate: | 09/06/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XH1200X | 027045 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Hand |
No ID Information.