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General NPI Number Information
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NPI Number | 1790905677
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Entity Type | Individual
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Provider Name | ROBERT LYNN SMELTZ NP.
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Gender | Male
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 12/13/2012
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Provider Practice Location Address
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Address Line | 760 BROADWAY-WOODHULL MEDICAL & MENTAL HEALTH CENTER
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City | BROOKLYN
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State | NY
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Zip | 11206
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Country | US
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Telephone | 718-963-8000
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Fax | 718-630-3122
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Provider Business Mailing Address
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Address Line | 760 BROADWAY - WOODHULL MEDICAL & MENTAL HEALTH CENTER DEPARTMENT OF MANAGED CARE ROOM 2B230
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City | BROOKLYN
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State | NY
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Zip | 11206
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Country | US
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Telephone | 718-963-8000
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Fax | 718-630-3122
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F440019-1
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License Number State | NY
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