Simon, Mitchell Lyle

Simon, Mitchell Lyle is an sole proprietor health care provider with primary practice located at 579A Cranbury Rd , East Brunswick NJ 08816-5426. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Simon, Mitchell Lyle can be contacted via phone (732) 390-0040.

Contact Information

Primary practice address
579A Cranbury Rd East Brunswick NJ 08816-5426
Phone: (732) 390-0040
Fax: (732) 390-1856
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Radiology 2085P0229X 25MA07729600 New Jersey
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 25MA07729600 New Jersey

Profile Details

NPI number 1225014780
LBN Legal business name Simon, Mitchell Lyle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 16th, 2005
Last updated Jan 6th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225014780 NPPES
New Jersey MEDICAID 0035661
New Jersey MEDICAID 02597226

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