MEDICARE: SIMON LEE MD

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
1	207Q00000X	Family Medicine Physician	25MA12751800	NJ

General Provider Information

NPI Number	:	1538801568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIMON LEE MD

Provider Business Mailing Address
First Line	:	799 BLOOMFIELD AVE STE 201
Second Line	:
City	:	VERONA
State	:	NJ
Zip	:	07044-1374
Country	:	US
Telephone Number	:	973-259-3563
Fax Number	:

Provider Business Practice Location Address
First Line	:	799 BLOOMFIELD AVE
Second Line	:
City	:	VERONA
State	:	NJ
Zip	:	07044-1367
Country	:	US
Telephone Number	:	973-259-3563
Fax Number	:

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

Provider Enumeration Date	:	04/11/2022
Last Update Date	:	02/06/2026

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Directions to “ SIMON LEE MD” Practice Location

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