Provider Demographics
NPI:1154476760
Name:SIMONE, JOSEPH J (DO)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:J
Last Name:SIMONE
Suffix:
Gender:M
Credentials:DO
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Other - Last Name:
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Mailing Address - Street 1:555 LITTLE EAST NECK RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-6538
Mailing Address - Country:US
Mailing Address - Phone:631-321-5444
Mailing Address - Fax:631-321-5445
Practice Address - Street 1:555 LITTLE EAST NECK RD
Practice Address - Street 2:SUITE 2
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-6538
Practice Address - Country:US
Practice Address - Phone:631-321-5444
Practice Address - Fax:631-321-5445
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY202631204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
H42731Medicare UPIN
NY93Q301Medicare ID - Type Unspecified