Individual
DR. SIMON CORREA GAVIRIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MMSC
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-4242
Mailing address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-4242
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1027330
MA
207RN0300X
Nephrology Physician
Primary
1027330
MA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/29/2021
Last updated
06/11/2026
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