Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 233987 | MA |
NPI | 1366638710 |
---|---|
Provider Name | Josef B Simon |
First Address | Brighton, MA 02135-2065 |
Second Address | Cambridge, MA 02138-5600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2007 |
Last Update Date | 07/08/2019 |