Provider Demographics
NPI:1912797325
Name:SIMON, HEATHER DAYNA
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:DAYNA
Last Name:SIMON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 HAZELNUT CT
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4243
Mailing Address - Country:US
Mailing Address - Phone:516-655-8763
Mailing Address - Fax:
Practice Address - Street 1:2330 UNION BLVD
Practice Address - Street 2:
Practice Address - City:ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11751-3172
Practice Address - Country:US
Practice Address - Phone:631-377-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist