Provider Demographics
NPI:1871608521
Name:CHIN, SIMON H (MD)
Entity type:Individual
Prefix:
First Name:SIMON
Middle Name:H
Last Name:CHIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:110 S BEDFORD RD
Mailing Address - Street 2:CARE MOUNT MEDICAL PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:111 BEDFORD RD
Practice Address - Street 2:CARE MOUNT MEDICAL PC
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536-2115
Practice Address - Country:US
Practice Address - Phone:914-232-3135
Practice Address - Fax:914-242-1516
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00046197207XS0106X
NY243028207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0667910001OtherDME
NYP00613054OtherMEDICARE RAILROAD
NY02941904Medicaid
NY2311606761Medicare PIN