Healthcare Provider Details

I. General information

NPI: 1740717206
Provider Name (Legal Business Name): FALANTE SIMEON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2017
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 MOUNT EBO RD N #191
BREWSTER NY
10509
US

IV. Provider business mailing address

3 MOUNT EBO RD N #191
BREWSTER NY
10509
US

V. Phone/Fax

Practice location:
  • Phone: 914-893-8385
  • Fax:
Mailing address:
  • Phone: 914-893-8385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF408164
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number781153
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number301555
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: