Provider Demographics
NPI:1013728955
Name:DOWNES, SIMON R (MD, PHD)
Entity type:Individual
Prefix:
First Name:SIMON
Middle Name:R
Last Name:DOWNES
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 TUDOR CITY PL APT B2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6855
Mailing Address - Country:US
Mailing Address - Phone:917-388-7552
Mailing Address - Fax:
Practice Address - Street 1:5 TUDOR CITY PL APT B2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6855
Practice Address - Country:US
Practice Address - Phone:917-388-7552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No174H00000XOther Service ProvidersHealth Educator