Individual
ROLAND THEODORE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
635 W 165TH ST, BOX 92, NEW YORK, NY 10032-3724
(212) 283-5222
Mailing address
635 W 165TH ST, BOX 92, NEW YORK, NY 10032-3724
(212) 283-5222
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
151173-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01113964
—
NY
Enumeration date
07/20/2006
Last updated
05/09/2013
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