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1124397021
SIMON NISSIM
BROOKLYN, NY
NPI
1124397021
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2011-12-21
Last Update Date
2011-12-21
Business Address
Mr. SIMON NISSIM ba
255 AVENUE W
BROOKLYN, NY 11223-5202
Phone number: 866-569-7233
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Mailing Address
Mr. SIMON NISSIM ba
255 AVENUE W
BROOKLYN, NY 11223-5202
Phone number: 866-569-7233
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