Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 25MA11150300 | NJ |
NPI | 1215384656 |
---|---|
Provider Name | Andrew Simon |
First Address | Camden, NJ 08103-1438 |
Second Address | Camden, NJ 08103-1438 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2016 |
Last Update Date | 18/11/2021 |