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General NPI Number Information
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NPI Number | 1043174576
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Entity Type | Individual
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Provider Name | DAVIANA SMITH RN, BSN
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Gender | Female
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Dates
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Enumeration Date | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 216 BROADHOLLOW ROAD SUITE 200
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City | MELVILLE
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State | NY
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Zip | 11747
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Country | US
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Telephone | 631-759-4445
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Fax |
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Provider Business Mailing Address
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Address Line | 2 GARFIELD ST APT 2B
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City | BAY SHORE
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State | NY
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Zip | 11706-7243
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Country | US
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Telephone | 347-335-9910
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 897486-01
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License Number State | NY
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