Healthcare Provider Details

I. General information

NPI: 1427042795
Provider Name (Legal Business Name): JUAN SIMON AFIF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2005
Last Update Date: 07/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1214 PELHAM PKWY S
BRONX NY
10461-1029
US

IV. Provider business mailing address

1214 PELHAM PKWY S
BRONX NY
10461-1029
US

V. Phone/Fax

Practice location:
  • Phone: 718-824-2200
  • Fax: 718-824-0849
Mailing address:
  • Phone: 718-824-2200
  • Fax: 718-824-0849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number123469
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: