Provider Demographics
NPI:1932346178
Name:SIMON, SAJI
Entity Type:Individual
Prefix:
First Name:SAJI
Middle Name:
Last Name:SIMON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60310
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-0310
Mailing Address - Country:US
Mailing Address - Phone:323-819-1934
Mailing Address - Fax:
Practice Address - Street 1:971 EAST LANCASTER AVENUE
Practice Address - Street 2:SAJI ENTERPRISES P.C. WELLNESS OFFICE
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335
Practice Address - Country:US
Practice Address - Phone:215-990-9015
Practice Address - Fax:888-477-8110
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-09
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005516213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine