Provider Demographics
NPI:1447513262
Name:WOLPIN SIMON, MIRIAM C (MS ED)
Entity type:Individual
Prefix:MRS
First Name:MIRIAM
Middle Name:C
Last Name:WOLPIN SIMON
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 ROCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-5357
Mailing Address - Country:US
Mailing Address - Phone:845-356-5798
Mailing Address - Fax:845-517-9221
Practice Address - Street 1:127 ROCK HILL RD
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-5357
Practice Address - Country:US
Practice Address - Phone:845-356-5798
Practice Address - Fax:845-517-9221
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2129566174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator