Healthcare Provider Details

I. General information

NPI: 1881605277
Provider Name (Legal Business Name): CHERIE ANDREA SMITH RN BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 08/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 8TH AVE 3RD FLOOR
NEW YORK NY
10018-6504
US

IV. Provider business mailing address

500 8TH AVE 3RD FLOOR
NEW YORK NY
10018-6504
US

V. Phone/Fax

Practice location:
  • Phone: 212-904-1500
  • Fax: 212-904-1444
Mailing address:
  • Phone: 212-904-1500
  • Fax: 212-904-1444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number2499141
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number581663-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: