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General NPI Number Information
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NPI Number | 1447094586
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Entity Type | Individual
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Provider Name | KRISTIANA LAUREANO SIMON PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/24/2024
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 43 PRINCETON HIGHTSTOWN RD # 3
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City | PRINCETON JUNCTION
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State | NJ
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Zip | 08550-1118
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Country | US
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Telephone | 609-955-3710
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Fax |
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Provider Business Mailing Address
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Address Line | 8 POPLAR LN # 8B
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City | OLD BRIDGE
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State | NJ
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Zip | 08857-4502
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Country | US
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Telephone | 386-847-1193
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00874700
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License Number State | NJ
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