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NPI Code Detail

MEDICARE: JANET SMITH

MEDICARE: JANET 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
1163W00000XRegistered Nurse611480NY

General Provider Information

NPI Number : 1508417981
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANET SMITH
Provider Business Mailing Address
First Line : 14202 20TH AVE
Second Line :
City : FLUSHING
State : NY
Zip : 11351-3000
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10154 117TH ST
Second Line :
City : SOUTH RICHMOND HILL
State : NY
Zip : 11419-1906
Country : US
Telephone Number : 718-846-4007
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2019
Last Update Date : 09/26/2019

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