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General NPI Number Information
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NPI Number | 1851365449
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Entity Type | Individual
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Provider Name | ROBERT M SIMON MD
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Gender | Male
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 05/04/2020
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Provider Practice Location Address
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Address Line | 6 HIGHRIDGE RD
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City | LARCHMONT
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State | NY
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Zip | 10538-1409
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Country | US
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Telephone | 917-853-2232
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Fax |
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Provider Business Mailing Address
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Address Line | 6 HIGHRIDGE RD
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City | LARCHMONT
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State | NY
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Zip | 10538-1409
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Country | US
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Telephone | 917-853-2232
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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 | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | 163710
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 035038
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 163710
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License Number State | NY
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