Provider Demographics
NPI:1952153702
Name:SIMON, ANTHONY (MS, DABR)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:
Last Name:SIMON
Suffix:
Gender:M
Credentials:MS, DABR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 WEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-1293
Mailing Address - Country:US
Mailing Address - Phone:724-448-4957
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY DRIVE
Practice Address - Street 2:BUILDING 1 ROOM BW 207
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15240
Practice Address - Country:US
Practice Address - Phone:412-360-1489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILP57832085R0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0205XAllopathic & Osteopathic PhysiciansRadiologyRadiological Physics