Provider Demographics
NPI:1932174737
Name:SCIMONE, ANTHONY (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:SCIMONE
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 BEVERLY RD
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009
Mailing Address - Country:US
Mailing Address - Phone:973-857-9783
Mailing Address - Fax:973-618-3477
Practice Address - Street 1:175 HIGH ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860
Practice Address - Country:US
Practice Address - Phone:973-579-8981
Practice Address - Fax:973-579-8718
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA653152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7597304Medicaid
NJ7597304Medicaid
G68063Medicare UPIN