Healthcare Provider Details

I. General information

NPI: 1114963907
Provider Name (Legal Business Name): JULIA SMITH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 E 34TH ST 3RD FL
NEW YORK NY
10016-4750
US

IV. Provider business mailing address

160 E 34TH ST 3RD FL
NEW YORK NY
10016-4750
US

V. Phone/Fax

Practice location:
  • Phone: 212-731-5365
  • Fax:
Mailing address:
  • Phone: 212-731-5365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number151407
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: