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NPI Code Detail

MEDICARE: LEANICE SMITH

MEDICARE: LEANICE SMITH
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
1101YP2500XProfessional Counselor37PC00578000NJ

General Provider Information

NPI Number : 1528581428
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEANICE SMITH
Provider Business Mailing Address
First Line : 270 ROOSEVELT AVE
Second Line :
City : PISCATAWAY
State : NJ
Zip : 08854-4807
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 71 ROUTE 206
Second Line :
City : HILLSBOROUGH
State : NJ
Zip : 08844-4142
Country : US
Telephone Number : 908-685-1887
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2017
Last Update Date : 07/23/2017

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Directions to “ LEANICE SMITH ” Practice Location

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