MEDICARE: MS. DEBRA SMITH MS:SPECIAL EDUCATIO

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	174400000X	Specialist	698974	NY

General Provider Information

NPI Number	:	1477425890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBRA SMITH MS:SPECIAL EDUCATIO

Provider Business Mailing Address
First Line	:	1482 ROYCE ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-5924
Country	:	US
Telephone Number	:	718-702-0391
Fax Number	:

Provider Business Practice Location Address
First Line	:	1482 ROYCE ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-5924
Country	:	US
Telephone Number	:	718-702-0391
Fax Number	:

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

Provider Enumeration Date	:	09/23/2025
Last Update Date	:	09/23/2025

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