Provider Demographics
NPI:1427042795
Name:AFIF, JUAN SIMON (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:SIMON
Last Name:AFIF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 PELHAM PKWY S
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1029
Mailing Address - Country:US
Mailing Address - Phone:718-824-2200
Mailing Address - Fax:718-824-0849
Practice Address - Street 1:1214 PELHAM PKWY S
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1029
Practice Address - Country:US
Practice Address - Phone:718-824-2200
Practice Address - Fax:718-824-0849
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-01
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY123469207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00232260Medicaid
NY00232260Medicaid
NYA61968Medicare UPIN