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NPI Code Detail

MEDICARE: ANTHONY SIMON

MEDICARE: ANTHONY SIMON
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist044132-1NY

General Provider Information

NPI Number : 1023672912
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY SIMON
Provider Business Mailing Address
First Line : 28 LEE AVE
Second Line :
City : BETHPAGE
State : NY
Zip : 11714-3608
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 150 BAY SHORE RD
Second Line :
City : NORTH BABYLON
State : NY
Zip : 11703-1711
Country : US
Telephone Number : 631-586-6616
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2019
Last Update Date : 04/25/2019

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Directions to “ ANTHONY SIMON ” Practice Location

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