Individual
GREGORY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
567 SAND HILL RD, WANTAGH, NY 11793-1312
(516) 417-3535
Mailing address
567 SAND HILL RD, WANTAGH, NY 11793-1312
(516) 417-3535
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
295025
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2015
Last updated
03/02/2020
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