Doctor Name: | DR. COREY B SIMON |
NPI Number: | 1114945581 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT, DPT |
License Number: | 026443 |
Business Practice Address: | 6301 Transit Rd Depew, NY - 140431051 |
Business Phone Number: | 7166840400 |
Business Fax Number: | |
Mailing Address: | 22 Willow Wood Dr, CHEEKTOWAGA |
State: | NY |
Postal Code: | 142254434 |
Phone Number: | 7166848728 |
Fax Number: | |
NPI Enumeration Date: | 07/17/2006 |
NPI Last Update Date: | 09/03/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251X0800X |
License Number: | 026443 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Orthopedic |
Taxonomy Definition: |