Individual
RAQUEL MARIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
83 MALLORY AVE APT 1L, JERSEY CITY, NJ 07304-1064
(201) 616-2276
Mailing address
83 MALLORY AVE APT 1L, JERSEY CITY, NJ 07304-1064
(201) 616-2276
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
40QB00387800
NJ
Other
Enumeration date
06/07/2022
Last updated
06/07/2022
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