Healthcare Provider Details

I. General information

NPI: 1821213539
Provider Name (Legal Business Name): MRS. ROSALYN BERNICE SMITHBEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 HARDING HWY
PITTSGROVE NJ
08318-4401
US

IV. Provider business mailing address

9 HARDING HWY
PITTSGROVE NJ
08318-4401
US

V. Phone/Fax

Practice location:
  • Phone: 856-358-4111
  • Fax: 856-358-4120
Mailing address:
  • Phone: 856-358-4111
  • Fax: 856-358-4120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: