Individual ProviderSimon BerheStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address630 W 168th St, New York, NY 10032(212) 305-2500PECOS EnrollmentBased on the most recent information from CMS, provider Simon Berhe is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1689171910Provider TypeIndividualFull NameBerhe, SimonCredentialMDGenderMaleSole ProprietorNoEnumeration Date4/12/2018Last Updated4/12/2018Contact InformationPractice LocationPractice Address630 W 168th St, New York, NY 10032Phone(212) 305-2500FaxUnlisted FaxMailing LocationMailing Address177 Ft Washingtn Ave # 7gs-313, New York, NY 10032-3733PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer