MEDICARE: SIMON R DOWNES MD, PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	103T00000X	Psychologist
2	174H00000X	Health Educator
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1013728955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIMON R DOWNES MD, PHD

Provider Business Mailing Address
First Line	:	5 TUDOR CITY PL APT B2
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-6855
Country	:	US
Telephone Number	:	917-388-7552
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 TUDOR CITY PL APT B2
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-6855
Country	:	US
Telephone Number	:	917-388-7552
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2025
Last Update Date	:	01/20/2025

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