Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 193007 | NY |
NPI | 1033170592 |
---|---|
Provider Name | Rayze Simonson |
First Address | Philadelphia, PA 19195-2388 |
Second Address | New York, NY 10024-5116 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2006 |
Last Update Date | 28/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F97965 | (02) | NY |