Provider Demographics
NPI:1043497506
Name:RICK L SIMON, DPM
Entity Type:Organization
Organization Name:RICK L SIMON, DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:215-362-2220
Mailing Address - Street 1:231 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-2520
Mailing Address - Country:US
Mailing Address - Phone:215-362-2220
Mailing Address - Fax:215-362-5307
Practice Address - Street 1:231 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-2520
Practice Address - Country:US
Practice Address - Phone:215-362-2220
Practice Address - Fax:215-362-5307
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RICK L SIMON, DPM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002656L332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1303140001Medicare NSC