Provider Demographics
NPI:1760200224
Name:SIMON, ASHLEY STARR (NP)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:STARR
Last Name:SIMON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 RICHARD AVE APT B1
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-1209
Mailing Address - Country:US
Mailing Address - Phone:516-376-7185
Mailing Address - Fax:
Practice Address - Street 1:2110 NORTHERN BLVD STE 205
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3500
Practice Address - Country:US
Practice Address - Phone:516-627-1811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311839363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health