Healthcare Provider Details

I. General information

NPI: 1124212014
Provider Name (Legal Business Name): ALOYSIUS G. SMITH MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2007
Last Update Date: 09/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 YONKERS AVE SUITE 17
YONKERS NY
10704
US

IV. Provider business mailing address

955 YONKERS AVE SUITE 17
YONKERS NY
10704
US

V. Phone/Fax

Practice location:
  • Phone: 914-237-6002
  • Fax:
Mailing address:
  • Phone: 914-237-6002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number134030
License Number State

VIII. Authorized Official

Name: DR. ALOYSIUS G. SMITH
Title or Position: DIRECTOR
Credential: M.D.
Phone: 914-237-6002