Individual
MATTHEW A SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 LODGE PL, WEST BABYLON, NY 11704-1608
(631) 901-8636
Mailing address
20 LODGE PL, WEST BABYLON, NY 11704-1608
(631) 901-8636
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-208267
NY
Other
Enumeration date
11/30/2023
Last updated
11/30/2023
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