Organization
LEGENDARII SMITH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK SMITH (PROVIDER)
(347) 692-6161
Entity
Organization
Contact information
Practice address
1828 PARKVIEW AVE APT 1, BRONX, NY 10461-4660
(347) 692-6161
Mailing address
1828 PARKVIEW AVE APT 1, BRONX, NY 10461-4660
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
01/07/2026
Last updated
01/07/2026
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