Individual
EDDY SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
310 CENTRAL AVENUE, SUITE 102, EAST ORANGE, NJ 07018
(973) 395-1550
(973) 395-1556
Mailing address
21 EDGEWOOD ROAD, SUMMIT, NJ 07901
(973) 395-1550
(973) 395-1556
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA062638
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6687504
—
NJ
Enumeration date
09/02/2005
Last updated
04/20/2019
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