Provider Demographics
NPI:1477551281
Name:SIMSON, ELKIN (MD)
Entity Type:Individual
Prefix:
First Name:ELKIN
Middle Name:
Last Name:SIMSON
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 1:50 FOX DEN RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3835
Mailing Address - Country:US
Mailing Address - Phone:914-241-1887
Mailing Address - Fax:914-666-7969
Practice Address - Street 1:50 FOX DEN RD
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3835
Practice Address - Country:US
Practice Address - Phone:914-241-1887
Practice Address - Fax:914-666-7969
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY140282207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH28617Medicare UPIN
NY01Q971Medicare ID - Type Unspecified