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NPI Code Detail

MEDICARE: SME CONNECTICUT PC

MEDICARE: SME CONNECTICUT PC
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
1208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1548734288
Entity Type Code : Organization
Provider Name (Legal Business Name) : SME CONNECTICUT PC
Provider Business Mailing Address
First Line : 4321 COLLINGTON RD
Second Line :
City : BOWIE
State : MD
Zip : 20716-2259
Country : US
Telephone Number : 646-673-1660
Fax Number :
Provider Business Practice Location Address
First Line : 4 LEGENDS CIR
Second Line :
City : MELVILLE
State : NY
Zip : 11747-5302
Country : US
Telephone Number : 646-673-1660
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. LEV GRINMAN
Credential : MD
Telephone Number : 646-673-1660
Provider Enumeration Date : 01/16/2019
Last Update Date : 08/03/2021

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Directions to “SME CONNECTICUT PC ” Practice Location

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