Provider Demographics
NPI:1316304868
Name:METZGER, SIMA B (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SIMA
Middle Name:B
Last Name:METZGER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MRS
Other - First Name:SIMI
Other - Middle Name:
Other - Last Name:MOSKOVITS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:5 ROSE GARDEN WAY
Mailing Address - Street 2:UNIT 102
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-7622
Mailing Address - Country:US
Mailing Address - Phone:845-645-5411
Mailing Address - Fax:
Practice Address - Street 1:5 ROSE GARDEN WAY
Practice Address - Street 2:UNIT 102
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-7622
Practice Address - Country:US
Practice Address - Phone:845-645-5411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-27
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025126235Z00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No252Y00000XAgenciesEarly Intervention Provider Agency