Individual
MS. JUDITH SADIAN SMITH-JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
546B BUCHANAN AVE, STATEN ISLAND, NY 10314-4159
(718) 782-0589
(718) 384-7715
Mailing address
546B BUCHANAN AVE, STATEN ISLAND, NY 10314
(718) 782-0589
(718) 384-7715
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
517231-1
NY
163WC1500X
Community Health Registered Nurse
517231-1
NY
163WM0705X
Medical-Surgical Registered Nurse
Primary
517231-1
NY
Other
Enumeration date
04/09/2012
Last updated
04/09/2012
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