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General NPI Number Information
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NPI Number | 1679940092
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Entity Type | Individual
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Provider Name | ALEXA SIMON PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/02/2015
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Last Update Date | 12/16/2015
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Provider Practice Location Address
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Address Line | 450 S EASTON RD
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City | GLENSIDE
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State | PA
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Zip | 19038-3215
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Country | US
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Telephone | 215-572-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 1 ROBERT WOOD JOHNSON PLACE
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08903-0019
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Country | US
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Telephone | 732-235-7670
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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