Individual
DR. MARY A. SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7 MELROSE DR, FARMINGTON, CT 06032-0893
(860) 677-1778
(860) 677-1730
Mailing address
7 MELROSE DR, FARMINGTON, CT 06032-0893
(860) 677-1778
(860) 677-1730
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
036049
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001 360 495
—
CT
Enumeration date
03/27/2007
Last updated
01/03/2013
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