Simonetti Realty Inc

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

102RH Issued in CT

Legal business name

SIMONETTI REALTY INC

Practice address

101 Marshall LN
Derby, CT 06418-2347

Phone

(203) 734-3393

Fax

(203) 734-2100

NPI assigned

May 2, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Patricia Ann McCallum

Title

Office Manager

Phone

(203) 734-3393

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• marshall lane manor Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326844800000",
    "number": "1578784658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MARSHALL LN",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064182347",
            "telephone_number": "203-734-3393",
            "fax_number": "203-734-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MARSHALL LN",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064182347",
            "telephone_number": "203-734-3393",
            "fax_number": "203-734-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMONETTI REALTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2012-01-18",
        "status": "A",
        "authorized_official_last_name": "MCCALLUM",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "203-734-3393"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "CT",
            "license": "102RH",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000091025",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "marshall lane manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bianca N Shuster, APRN
• Aanu Sihota, M.D.
• Angelina R Silva, FNP-BC
• Julie Sim, CRNA
• Margot A Simeone
• Dinesh Singh, MD
• Gayle Singleton, MSW
• Melissa Paige Sipos, RDH
• Merton A Smith, MD
• Michele L Smith, LCSW

• Nursing Facility/Intermediate Care Facility in Derby, CT
• Providers in Derby, CT by specialty
• Nursing Facility/Intermediate Care Facility in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.