Provider Demographics
NPI:1124138557
Name:SIMON, KAREN (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:SIMON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 E 19TH ST
Mailing Address - Street 2:8TH FLOOR, BLDG 'C'
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-2602
Mailing Address - Country:US
Mailing Address - Phone:212-995-7410
Mailing Address - Fax:212-995-7411
Practice Address - Street 1:227 E 19TH ST
Practice Address - Street 2:8TH FLOOR, BLDG 'C'
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2602
Practice Address - Country:US
Practice Address - Phone:212-995-7410
Practice Address - Fax:212-995-7411
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY162539207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0125409OtherGHI PPO
NY01173528Medicaid
NY165253960NYOtherLOCAL 1199
NY0125409OtherGHI PPO
NY01173528Medicaid