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General NPI Number Information
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NPI Number | 1316184005
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Entity Type | Organization
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Legal Business Name | SIMON FAYNZILBERGMD PC
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Dates
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Enumeration Date | 01/16/2009
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Last Update Date | 01/16/2009
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Provider Practice Location Address
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Address Line | 157 WINTHROP RD UNIT 2
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City | BROOKLINE
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State | MA
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Zip | 02445-4642
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Country | US
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Telephone | 617-817-2070
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Fax | 617-232-0515
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Provider Business Mailing Address
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Address Line | 157 WINTHROP RD UNIT 2
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City | BROOKLINE
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State | MA
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Zip | 02445-4642
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Country | US
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Telephone | 617-817-2070
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Fax | 617-232-0515
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SIMON FAYNZILBERG
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Credential |
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Telephone | 617-817-2070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 160820
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | 160820
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 160820
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License Number State | MA
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