Individual
JENNA ROSE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
540 FULTON AVE, HEMPSTEAD, NY 11550-4364
(516) 750-2500
Mailing address
540 FULTON AVE, HEMPSTEAD, NY 11550-4364
(516) 750-2500
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
020030-1
NY
Other
Enumeration date
09/12/2016
Last updated
07/21/2022
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