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Individual

MR. JASON G SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
267 GRANT ST, BRIDGEPORT, CT 06610-2805
(203) 384-3072
(203) 384-4619
Mailing address
7365 MAIN ST, SUITE 310, STRATFORD, CT 06614-1300
(203) 384-3072
(203) 384-4619

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
004146
CT
367500000X
Certified Registered Nurse Anesthetist
Primary
071219
CT

Other

Enumeration date
07/02/2009
Last updated
03/17/2018
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