Provider Demographics
NPI:1386679694
Name:KAHN, SIMON J (MD)
Entity Type:Individual
Prefix:DR
First Name:SIMON
Middle Name:J
Last Name:KAHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:464 HUDSON TER
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2902
Mailing Address - Country:US
Mailing Address - Phone:201-567-2206
Mailing Address - Fax:201-567-1120
Practice Address - Street 1:464 HUDSON TER
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-2902
Practice Address - Country:US
Practice Address - Phone:201-567-2206
Practice Address - Fax:201-567-1120
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA043165207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ562967VHNMedicare PIN