Provider Demographics
NPI:1548986870
Name:SIMNICA, GENTIANA
Entity type:Individual
Prefix:
First Name:GENTIANA
Middle Name:
Last Name:SIMNICA
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 1:1347 E 17TH ST APT 1C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-6021
Mailing Address - Country:US
Mailing Address - Phone:718-501-2011
Mailing Address - Fax:
Practice Address - Street 1:1347 E 17TH ST APT 1C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-6021
Practice Address - Country:US
Practice Address - Phone:718-501-2011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
90800496800OtherUNITED HEALTHCARE OXFORD