Evan Simonsen
Student in an Organized Health Care Education/Training Program in Albany, NY. Individual provider (NPI-1).
NPI number1245033752
StatusActive
Last updated in NPPESMar 31, 2025
Details
- NPI
- 1245033752
- Entity type
- Individual (NPI-1)
- Name
- Evan Simonsen
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 31, 2025
- Certification date
- Mar 30, 2025
- Last updated
- Mar 31, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | 65156 | NY | Yes |
Practice location
2 Clara Barton DrAlbany, NY 12208-3472
Phone 518-262-5511
Mailing address
2 Clara Barton Dr Ste 164Albany, NY 12208-3477
Phone 518-262-5511
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