MEDICARE: FALLON SHEY SIMONETTI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	071201	NY

General Provider Information

NPI Number	:	1356294870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FALLON SHEY SIMONETTI

Provider Business Mailing Address
First Line	:	147 WOODVALE AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10309-3522
Country	:	US
Telephone Number	:	917-742-8335
Fax Number	:

Provider Business Practice Location Address
First Line	:	147 WOODVALE AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10309-3522
Country	:	US
Telephone Number	:	917-742-8335
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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Directions to “ FALLON SHEY SIMONETTI ” Practice Location

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