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General NPI Number Information
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NPI Number | 1962638056
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Entity Type | Individual
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Provider Name | SIMON ROH M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/03/2009
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 3735 NAZARETH RD STE 206
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City | EASTON
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State | PA
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Zip | 18045-8346
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Country | US
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Telephone | 484-526-4805
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Fax |
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Provider Business Mailing Address
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Address Line | 3735 NAZARETH RD STE 206
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City | EASTON
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State | PA
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Zip | 18045-8346
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Country | US
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Telephone |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 39717
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 288048
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 25MA10399800
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | MD464827
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License Number State | PA
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