Healthcare Provider Details

I. General information

NPI: 1144782202
Provider Name (Legal Business Name): MARIALAURA SIMONETTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2019
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 EAST 70TH ST STARR PAVILION, 607
NEW YORK NY
10021
US

IV. Provider business mailing address

520 E 70TH ST
NEW YORK NY
10021-9800
US

V. Phone/Fax

Practice location:
  • Phone: 212-745-2334
  • Fax:
Mailing address:
  • Phone: 305-873-3216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number324410
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: