Individual
SHAWN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
434 ROCKAWAY PKWY, BROOKLYN, NY 11212-3248
(646) 217-1774
Mailing address
434 ROCKAWAY PKWY, BROOKLYN, NY 11212-3248
(646) 217-1774
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
5711481
NY
Other
Enumeration date
06/30/2010
Last updated
06/30/2010
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