Healthcare Provider Details

I. General information

NPI: 1124026968
Provider Name (Legal Business Name): PHILIPPE LOUIS SIMILON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 PARK AVE
NEW YORK NY
10128-1234
US

IV. Provider business mailing address

1111 PARK AVE
NEW YORK NY
10128-1234
US

V. Phone/Fax

Practice location:
  • Phone: 212-534-3000
  • Fax: 212-996-8420
Mailing address:
  • Phone: 212-534-3000
  • Fax: 212-996-8420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number218733
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: