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NPI Code Detail

MEDICARE: SIMON Z DJEN MD

MEDICARE: SIMON Z DJEN 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
1207Q00000XFamily Medicine Physician224469NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578648770
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIMON Z DJEN MD
Provider Business Mailing Address
First Line : 60 MADISON AVE
Second Line : FLOOR 6 COMMUNITY HEALTHCARE NETWORK INC
City : NEW YORK
State : NY
Zip : 10010-1600
Country : US
Telephone Number : 212-545-2439
Fax Number : 646-312-0481
Provider Business Practice Location Address
First Line : 150 ESSEX ST
Second Line :
City : NEW YORK
State : NY
Zip : 10002-2301
Country : US
Telephone Number : 212-477-1120
Fax Number : 212-477-8957
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2006
Last Update Date : 10/27/2016

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Directions to “ SIMON Z DJEN MD” Practice Location

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