Healthcare Provider Details

I. General information

NPI: 1548299449
Provider Name (Legal Business Name): ARI MENACHEM SIMCKES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 04/13/2021
Certification Date: 04/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 N MAIN ST REFUAH HEALTH CENTER
SPRING VALLEY NY
10977-1960
US

IV. Provider business mailing address

24050 COMMERCE PARK STE 100
BEACHWOOD OH
44122-5831
US

V. Phone/Fax

Practice location:
  • Phone: 845-354-9300
  • Fax: 845-354-9448
Mailing address:
  • Phone: 216-896-9301
  • Fax: 216-896-9302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number180413
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License Number180413
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME120471
License Number StateFL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier01421705
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: