Individual
DR. JOHN W SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
920 ALBANY SHAKER RD, SUITE 101, LATHAM, NY 12110
(518) 533-6502
(518) 533-6505
Mailing address
920 ALBANY SHAKER RD, SUITE 101, LATHAM, NY 12110
(518) 533-6502
(518) 533-6505
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
134338
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000406953005
BLUE SHIELD
NY
05
—
00652988
—
NY
01
—
0499000
GHI
NY
01
—
10006172
CDPHP
NY
05
—
1001534
—
VT
01
—
17149
MVP
NY
01
—
180045196
RAILROAD MEDICARE
NY
01
—
206233
WELLCARE
NY
01
—
409A91
BLUE CROSS
NY
01
—
58812
GHI HMO
NY
Enumeration date
04/19/2006
Last updated
04/10/2023
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