Provider Demographics
NPI:1346128352
Name:SIMON, TAMARY
Entity type:Individual
Prefix:
First Name:TAMARY
Middle Name:
Last Name:SIMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38464 OAK HILL LN APT 1
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-7646
Mailing Address - Country:US
Mailing Address - Phone:440-537-0886
Mailing Address - Fax:
Practice Address - Street 1:38464 OAK HILL LN APT 1
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-7646
Practice Address - Country:US
Practice Address - Phone:440-537-0886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No172A00000XOther Service ProvidersDriver
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
No385H00000XRespite Care FacilityRespite Care