Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 202631 | NY |
NPI | 1154476760 |
---|---|
Provider Name | Joseph J Simone |
First Address | West Babylon, NY 11704-6538 |
Second Address | West Babylon, NY 11704-6538 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 13/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H42731 | (02) |