Individual
PHYLLIS SIMON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
180 E PULASKI RD, HUNTINGTON STATION, NY 11746-1915
(631) 425-2121
(631) 425-2193
Mailing address
180 E PULASKI RD, HUNTINGTON STATION, NY 11746-1915
(631) 425-2121
(631) 425-2193
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
144918-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00718396
—
NY
Enumeration date
07/06/2005
Last updated
07/08/2007
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