Individual
MR. SIMOND SIUKI TAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
N/A
Contact information
Practice address
130 W KINGSBRIDGE RD, BRONX, NY 10468-3904
(718) 584-9000
Mailing address
72 SHAWNEE AVE APT 2, YONKERS, NY 10710-5155
(914) 420-9384
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
003161-1
NY
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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