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NPI Code Detail

MEDICARE: DR. CASEY KENT SMITH MD, JD

MEDICARE: DR. CASEY KENT SMITH MD, JD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician286071NY

General Provider Information

NPI Number : 1316365612
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CASEY KENT SMITH MD, JD
Provider Business Mailing Address
First Line : 102 RIVERS EDGE RD
Second Line : D15B OFFICE 1525A
City : NEW YORK
State : NY
Zip : 10035-1163
Country : US
Telephone Number : 646-766-5871
Fax Number : 646-517-3593
Provider Business Practice Location Address
First Line : 102 RIVERS EDGE RD
Second Line :
City : NEW YORK
State : NY
Zip : 10035-1163
Country : US
Telephone Number : 646-766-5871
Fax Number : 646-517-3593
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2014
Last Update Date : 11/06/2025

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