Individual
ALFONSO SO SIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
740 64TH ST, BROOKLYN, NY 11220-4714
(718) 439-2000
(718) 439-2196
Mailing address
7952 211TH ST, OAKLAND GARDENS, NY 11364-3226
(718) 439-2000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
126356
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00468539
—
NY
Enumeration date
09/22/2005
Last updated
07/08/2007
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