Healthcare Provider Details

I. General information

NPI: 1992993513
Provider Name (Legal Business Name): DR. MICHAEL C. SMATT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2007
Last Update Date: 02/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 MADISON AVE SUITE 1709
NEW YORK NY
10017-6304
US

IV. Provider business mailing address

295 MADISON AVE SUITE 1709
NEW YORK NY
10017-6304
US

V. Phone/Fax

Practice location:
  • Phone: 212-684-5811
  • Fax: 212-684-5813
Mailing address:
  • Phone: 212-684-5811
  • Fax: 212-684-5813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number2875
License Number StateNY

VIII. Authorized Official

Name: DR. MICHAEL C. SMATT
Title or Position: OWNER
Credential: D.C.
Phone: 212-684-5811