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NPI Code Detail

MEDICARE: STEPHAN B SIMONS MD

MEDICARE: STEPHAN B SIMONS 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
1207R00000XInternal Medicine Physician118268NY

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 : 1710928304
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHAN B SIMONS MD
Provider Business Mailing Address
First Line : 1211 WHITE PLAINS RD
Second Line :
City : BRONX
State : NY
Zip : 10472-4900
Country : US
Telephone Number : 718-828-6610
Fax Number : 718-829-9132
Provider Business Practice Location Address
First Line : 1211 WHITE PLAINS RD
Second Line :
City : BRONX
State : NY
Zip : 10472-4900
Country : US
Telephone Number : 718-828-6610
Fax Number : 718-829-9132
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2006
Last Update Date : 12/05/2011

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