Provider Demographics
NPI:1942208483
Name:SIMKOVIC, NEAL A (MD)
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:A
Last Name:SIMKOVIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 220389
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11022-0389
Mailing Address - Country:US
Mailing Address - Phone:718-263-6661
Mailing Address - Fax:718-263-4482
Practice Address - Street 1:11821 QUEENS BLVD
Practice Address - Street 2:SUITE 405
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-7201
Practice Address - Country:US
Practice Address - Phone:718-263-6661
Practice Address - Fax:718-263-4482
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY141796207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA99743Medicare UPIN
NY58159GMedicare PIN