MRS. PHYLLIS G SIMON-GOLDMAN MD NPI 1245431477

NPI Information

  • NPI: 1245431477
  • Provider Name: MRS. PHYLLIS G SIMON-GOLDMAN, MD
  • Classification: Pediatrics - 2080A0000X
  • Specialization: Adolescent Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 270 UNION AVE
    HOLBROOK, NY
    ZIP 11741
  • Phone: (631) 331-6200

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NPI Details

MRS. Phyllis G Simon-goldman, MD is an adolescent medicine pediatrics in Holbrook, NY with 21 years of experience. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. MRS. Phyllis G Simon-goldman, MD NPI is 1245431477. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

270 UNION AVE
HOLBROOK, NY
ZIP 11741
Phone: (631) 331-6200
Fax: (631) 331-6282

The NPI 1245431477 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/28/2007 and was last updated on 4/12/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080A0000XPediatricsAdolescent Medicine240746-1NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
103080866MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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