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General NPI Number Information
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NPI Number | 1972584167
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Entity Type | Individual
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Provider Name | MIRELA SIMON MD
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Gender | Female
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 11/01/2025
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Provider Practice Location Address
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Address Line | 330 BROOKLINE AVE
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City | BOSTON
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State | MA
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Zip | 02215-5400
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Country | US
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Telephone | 617-667-1856
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Fax | 617-726-9250
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Provider Business Mailing Address
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Address Line | PO BOX 9142
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City | CHARLESTOWN
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State | MA
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Zip | 02129-9142
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Country | US
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Telephone | 617-724-2655
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Fax | 617-726-9250
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 209995
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License Number State | MA
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