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Individual

ELIZABETH SIMON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
6045 KENNEDY BLVD, NORTH BERGEN, NJ 07047-3246
(201) 861-4443
(201) 861-0941
Mailing address
6045 KENNEDY BLVD, NORTH BERGEN, NJ 07047-3246
(201) 861-4443
(201) 861-0941

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
255146-1
NY
207R00000X
Internal Medicine Physician
Primary
25MB08657400
NJ

Other

Enumeration date
10/21/2009
Last updated
08/13/2012
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