Provider Demographics
NPI:1225117591
Name:SIMS, DAVID H (DPM)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:H
Last Name:SIMS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5307 MURRAY CT
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-2951
Mailing Address - Country:US
Mailing Address - Phone:973-303-1648
Mailing Address - Fax:973-334-2217
Practice Address - Street 1:5307 MURRAY CT
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-2951
Practice Address - Country:US
Practice Address - Phone:973-303-1648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2024-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00152300213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1350609-01Medicaid
T51051Medicare UPIN
NJ1350609-01Medicaid