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General NPI Number Information
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NPI Number | 1356360549
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Entity Type | Organization
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Legal Business Name | SMITH OPTOMETRY PC
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 04/07/2012
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Provider Practice Location Address
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Address Line | 401 E 34TH ST SOUTH 3B
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City | NEW YORK
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State | NY
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Zip | 10016-4914
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Country | US
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Telephone | 212-679-0766
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Fax |
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Provider Business Mailing Address
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Address Line | 401 E 34TH ST SOUTH 3B
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City | NEW YORK
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State | NY
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Zip | 10016-4914
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Country | US
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Telephone | 212-679-0766
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KENNETH C SMITH
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Credential |
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Telephone | 212-679-0766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV005868
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License Number State | NY
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