Provider Demographics
NPI:1336239672
Name:SIMCHA BEN-DAVID MD PLLC
Entity Type:Organization
Organization Name:SIMCHA BEN-DAVID MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIMCHA
Authorized Official - Middle Name:B
Authorized Official - Last Name:BEN-DAVID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-435-6363
Mailing Address - Street 1:5211 16 AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204
Mailing Address - Country:US
Mailing Address - Phone:718-435-6363
Mailing Address - Fax:718-438-8248
Practice Address - Street 1:5211 16 AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204
Practice Address - Country:US
Practice Address - Phone:718-435-6363
Practice Address - Fax:718-438-8248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY135036207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B11959Medicare UPIN
NY27A231Medicare PIN