Individual
SAM SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
4200 MONUMENT ROAD, OUTPATIENT BUILDING, PHILADELPHIA, PA 19131-1689
(215) 877-2000
Mailing address
4200 MONUMENT ROAD, OUTPATIENT BUILDING, PHILADELPHIA, PA 19131-1689
(215) 877-2000
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
RN675125
PA
Other
Enumeration date
09/08/2022
Last updated
09/08/2022
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