Basic Information
Provider Information
NPI: 1477541555
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SIMPKINS
FirstName: HENRY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 EDGEWATER ST
Address2: 6TH FL. PAYER RELATIONS
City: STATEN ISLAND
State: NY
PostalCode: 103054900
CountryCode: US
TelephoneNumber: 7182261008
FaxNumber: 7182261039
Practice Location
Address1: 1 EDGEWATER PLAZA
Address2: 1ST FL. LAB
City: STATEN ISLAND
State: NY
PostalCode: 103054900
CountryCode: US
TelephoneNumber: 7182264133
FaxNumber: 7182264185
Other Information
ProviderEnumerationDate: 10/12/2005
LastUpdateDate: 04/01/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0101X162496NYY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
207ZP0105X162496NYN Allopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine

No ID Information.


Home