Organization
MEDICAL OFFICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE RODRIGUEZ SIMPAO JR. MD (PHYSICIAN)
(718) 388-7283
Entity
Organization
Contact information
Practice address
765 GRAND ST, BROOKLYN, NY 11211-5797
(718) 388-7283
(718) 963-3410
Mailing address
765 GRAND ST, BROOKLYN, NY 11211-5797
(718) 388-7283
(718) 963-3410
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
162398
NY
208D00000X
General Practice Physician
162398
NY
Other
Enumeration date
05/23/2016
Last updated
05/23/2016
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