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NPI Code Detail

MEDICARE: RENATA SMITH

MEDICARE: RENATA 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
1174400000XSpecialistNY

General Provider Information

NPI Number : 1265794788
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENATA SMITH
Provider Business Mailing Address
First Line : 331 TECUMSEH AVE
Second Line :
City : MOUNT VERNON
State : NY
Zip : 10553-1904
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 20 CEDAR ST
Second Line :
City : NEW ROCHELLE
State : NY
Zip : 10801-5247
Country : US
Telephone Number : 914-576-5292
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2012
Last Update Date : 12/21/2025

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Directions to “ RENATA SMITH ” Practice Location

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