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General NPI Number Information
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NPI Number | 1487718656
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Entity Type | Organization
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Legal Business Name | GEORGE P. SMITH M.D.,P.C.
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 06/02/2008
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Provider Practice Location Address
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Address Line | 405 ARDEN AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10312-1218
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Country | US
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Telephone | 718-608-1111
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Fax | 718-608-1112
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Provider Business Mailing Address
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Address Line | 405 ARDEN AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10312-1218
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Country | US
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Telephone | 718-608-1111
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Fax | 718-608-1112
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GEORGE PHILIP SMITH
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Credential | M.D.
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Telephone | 718-608-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 204803
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License Number State | NY
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