Provider Demographics
NPI:1548017049
Name:SIMMS, KIMONE REGINA SAMANTHA (MD)
Entity type:Individual
Prefix:
First Name:KIMONE
Middle Name:REGINA SAMANTHA
Last Name:SIMMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 FIRST AVENUE
Mailing Address - Street 2:ROOM 523
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:212-423-7834
Mailing Address - Fax:212-534-7831
Practice Address - Street 1:1901 FIRST AVENUE
Practice Address - Street 2:ROOM 523
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-423-7834
Practice Address - Fax:212-534-7831
Is Sole Proprietor?:No
Enumeration Date:2024-05-02
Last Update Date:2025-01-10
Deactivation Date:2025-01-02
Deactivation Code:
Reactivation Date:2025-01-10
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program