Provider Demographics
NPI:1417027657
Name:JOSEPH J SIMONE, DO, PC
Entity Type:Organization
Organization Name:JOSEPH J SIMONE, DO, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:SIMONE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:631-324-5444
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY202631204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWDW521Medicare ID - Type Unspecified