MEDICARE: DR. NAOMI SMUKLER M.D.

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
1	207L00000X	Anesthesiology Physician	MA09564900	NJ
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207L00000X	Anesthesiology Physician	25MA09564900	NJ

General Provider Information

NPI Number	:	1417185547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAOMI SMUKLER M.D.

Provider Business Mailing Address
First Line	:	30 DE KOVEN CT
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-1708
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 DE KOVEN CT
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-1708
Country	:	US
Telephone Number	:	917-685-5906
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2009
Last Update Date	:	11/23/2020

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