Provider Demographics
NPI:1396077699
Name:SIMINOVICH-BLOK, BARBARA ANDREA (ND, LAC)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:ANDREA
Last Name:SIMINOVICH-BLOK
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 W 35TH ST
Mailing Address - Street 2:GROUND FLOOR C/O ASPIRE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2505
Mailing Address - Country:US
Mailing Address - Phone:732-841-5127
Mailing Address - Fax:
Practice Address - Street 1:248 W 35TH ST
Practice Address - Street 2:GROUND FLOOR C/O ASPIRE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-2505
Practice Address - Country:US
Practice Address - Phone:732-841-5127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT427175F00000X
NY004754-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist