Individual
MRS. TERESA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
34 BEAUMONT LANE, LAKE GROVE, NY 11755-2704
(631) 737-0725
Mailing address
34 BEAUMONT LANE, LAKE GROVE, NY 11755-2704
(631) 737-0725
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
315677-1
NY
Other
Enumeration date
09/04/2008
Last updated
09/04/2008
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