# MEDICAL OFFICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215384912
- **Authorized official:** DR. JOSE RODRIGUEZ SIMPAO JR. MD (PHYSICIAN)
- **Authorized official phone:** (718) 388-7283

## Contact information

- **Practice address:** 765 GRAND ST, BROOKLYN, NY 11211-5797
- **Practice address phone:** (718) 388-7283
- **Practice address fax:** (718) 963-3410
- **Mailing address:** 765 GRAND ST, BROOKLYN, NY 11211-5797
- **Mailing address phone:** (718) 388-7283
- **Mailing address fax:** (718) 963-3410

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | 162398 | NY | Yes |
| 208D00000X | General Practice Physician | 162398 | NY | — |

## Other

- **Enumeration date:** 05/23/2016
- **Last updated:** 05/23/2016