Healthcare Provider Details

I. General information

NPI: 1013043579
Provider Name (Legal Business Name): SIMIN SOLTANI FRISK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 02/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 WILLIAM ST SUITE 288 WEILL CORNELL MEDICINE LMH,
NEW YORK NY
10038-2612
US

IV. Provider business mailing address

234 SEVENTH AVE
PELHAM NY
10803-1312
US

V. Phone/Fax

Practice location:
  • Phone: 212-312-5243
  • Fax: 212-312-5855
Mailing address:
  • Phone: 504-228-0025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberM.D. 201101
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: