Healthcare Provider Details

I. General information

NPI: 1316186448
Provider Name (Legal Business Name): MARGARET MAY SMELLIE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2009
Last Update Date: 10/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1285 FULTON AVENUE LIFE RECOVERY CENTER
BRONX NY
10456
US

IV. Provider business mailing address

1285 FULTON AVE BRONX LEBANON HOSPITAL-LIFE RECOVERY CENTER
BRONX NY
10456-3401
US

V. Phone/Fax

Practice location:
  • Phone: 718-518-3700
  • Fax:
Mailing address:
  • Phone: 718-518-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number72-072750
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: