Organization
GEOFFREY SIMON MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY SIMON MD (OWNER)
(315) 738-0647
Entity
Organization
Contact information
Practice address
1656 CHAMPLIN AVE, SUITE 203, UTICA, NY 13502-4830
(315) 738-0647
(315) 738-9719
Mailing address
1656 CHAMPLIN AVE, SUITE 203, UTICA, NY 13502-4830
(315) 738-0647
(315) 738-9719
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
105165
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00590047
—
NY
Enumeration date
06/19/2007
Last updated
08/22/2020
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