| Doctor Name: | DR. LLOYD SIMON |
| NPI Number: | 1811921463 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 153210-1 |
| Business Practice Address: | 44210 County Road 48 Southold, NY - 119715032 |
| Business Phone Number: | 6317654150 |
| Business Fax Number: | 6317654688 |
| Mailing Address: | Po Box 1341, SOUTHOLD |
| State: | NY |
| Postal Code: | 119710963 |
| Phone Number: | 6317654150 |
| Fax Number: | 6317654688 |
| NPI Enumeration Date: | 07/10/2006 |
| NPI Last Update Date: | 04/06/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RA0401X |
| License Number: | 153210-1 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Addiction Medicine |
| Taxonomy Definition: | An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |