Individual
NICOLE A SMYTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
580 WOODROW RD, STATEN ISLAND, NY 10312-1230
(917) 369-0609
Mailing address
580 WOODROW RD, STATEN ISLAND, NY 10312-1230
(917) 369-0609
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
02/06/2024
Last updated
02/06/2024
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