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NPI Code Detail

MEDICARE: DAJAH SMITH

MEDICARE: DAJAH SMITH
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
1363LF0000XFamily Nurse Practitioner359158NY

General Provider Information

NPI Number : 1043150261
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAJAH SMITH
Provider Business Mailing Address
First Line : 2626 HALPERIN AVE
Second Line :
City : BRONX
State : NY
Zip : 10461-2631
Country : US
Telephone Number : 718-618-0401
Fax Number :
Provider Business Practice Location Address
First Line : 2015 GRAND CONCOURSE
Second Line :
City : BRONX
State : NY
Zip : 10453-4303
Country : US
Telephone Number : 718-583-7736
Fax Number : 347-479-1303
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2026
Last Update Date : 03/30/2026

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