Individual
MR. JONATHAN T SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22 WESTFIELD AVE, ANSONIA, CT 06401
(203) 736-9919
(203) 735-2055
Mailing address
67 MAPLE AVE FL 2, DERBY, CT 06418-1328
(203) 732-1330
(203) 732-1332
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
234884
NY
207R00000X
Internal Medicine Physician
Primary
46849
CT
207RG0100X
Gastroenterology Physician
234884
NY
207RG0100X
Gastroenterology Physician
46849
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008002867
—
CT
Enumeration date
05/16/2006
Last updated
09/26/2018
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