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General NPI Number Information
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NPI Number | 1801150693
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Entity Type | Individual
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Provider Name | MIHAILO SMILJANIC MSED
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Gender | Male
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Dates
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Enumeration Date | 06/27/2012
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Last Update Date | 06/27/2012
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Provider Practice Location Address
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Address Line | 242 E 83RD ST 5C
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City | NEW YORK
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State | NY
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Zip | 10028-3400
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Country | US
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Telephone | 267-879-0019
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Fax | 917-210-3216
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Provider Business Mailing Address
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Address Line | 242 E 83RD ST 5C
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City | NEW YORK
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State | NY
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Zip | 10028-3400
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Country | US
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Telephone | 267-879-0019
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Fax | 917-210-3216
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 1881524
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License Number State | NY
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