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General NPI Number Information
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NPI Number | 1871010736
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Entity Type | Individual
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Provider Name | TAMARA Y SMITH NP
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Gender | Female
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Dates
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Enumeration Date | 08/23/2017
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Last Update Date | 01/27/2024
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Provider Practice Location Address
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Address Line | 76 S CENTRAL AVE STE 1A
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City | VALLEY STREAM
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State | NY
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Zip | 11580-5405
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Country | US
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Telephone | 516-284-7521
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Fax | 516-475-2600
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Provider Business Mailing Address
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Address Line | 1595 N CENTRAL AVE APT 39
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City | VALLEY STREAM
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State | NY
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Zip | 11580-1186
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Country | US
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Telephone | 516-284-7521
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Fax | 516-475-2600
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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 | 654591
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 308468
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 308468
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License Number State | NY
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