Provider Demographics
NPI:1417260027
Name:ASSEFI, SIMA (MD)
Entity Type:Individual
Prefix:DR
First Name:SIMA
Middle Name:
Last Name:ASSEFI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 BUTLER PIKE
Mailing Address - Street 2:APT 159
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-3156
Mailing Address - Country:US
Mailing Address - Phone:484-532-7480
Mailing Address - Fax:
Practice Address - Street 1:1801 BUTLER PIKE
Practice Address - Street 2:APT 159
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-3156
Practice Address - Country:US
Practice Address - Phone:484-532-7480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT198052207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine