Organization
DR. SIMON CHAO, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIMON CHAO MD (SOLE MBR)
(215) 668-4693
Entity
Organization
Contact information
Practice address
33 UPTON ST UNIT 3, BOSTON, MA 02118-1609
(215) 668-4693
Mailing address
33 UPTON ST UNIT 3, BOSTON, MA 02118-1609
(215) 668-4693
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
238724
MEDICAL LIC
MA
Enumeration date
09/28/2018
Last updated
09/28/2018
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