Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 010315-1 | NY |
N | 103T00000X | Psychologist | 010315-1 | NY |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 010315-1 | NY |
N | 103G00000X | Clinical Psychologist | 010315-1 | NY |
N | 103TC0700X | Clinical Psychologist | 010315-1 | NY |
N | 103TH0100X | Health Service | 010315-1 | NY |
N | 103TP2701X | Group Psychotherapist | 010315-1 | NY |
NPI | 1447394283 |
---|---|
Provider Name | Dr. J. Joseph De Simone |
First Address | New York, NY 10023-7603 |
Second Address | New York, NY 10023-7603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2007 |
Last Update Date | 08/07/2007 |