MEDICARE: PEDRO SMUKLER

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	332B00000X	Durable Medical Equipment & Medical Supplies	N004149	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164736625
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDRO SMUKLER

Provider Business Mailing Address
First Line	:	30 DE KOVEN CT
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-1708
Country	:	US
Telephone Number	:	718-388-5770
Fax Number	:	718-975-3395

Provider Business Practice Location Address
First Line	:	88 SEIGEL ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11206-3203
Country	:	US
Telephone Number	:	718-388-5770
Fax Number	:	718-975-3395

Authorized Official
Title or Position	:	OWNER
Name	:	DR. PEDRO SMUKLER
Credential	:	DPM
Telephone Number	:	917-804-9722

Provider Enumeration Date	:	07/27/2010
Last Update Date	:	07/27/2010

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Directions to “PEDRO SMUKLER ” Practice Location

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