Healthcare Provider Details

I. General information

NPI: 1265349153
Provider Name (Legal Business Name): MERANTE SMITH
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8429 155TH AVE APT 3K
HOWARD BEACH NY
11414-2214
US

IV. Provider business mailing address

8429 155TH AVE APT 3K
HOWARD BEACH NY
11414-2214
US

V. Phone/Fax

Practice location:
  • Phone: 347-634-1230
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberN55072
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: