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Individual

AVERY SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
777 SEAVIEW AVE, STATEN ISLAND, NY 10305-3409
(718) 668-8078
(718) 668-0870
Mailing address
777 SEAVIEW AVE, STATEN ISLAND, NY 10305-3409
(718) 668-8078
(718) 668-8070

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
02/10/2012
Last updated
02/10/2012
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  • EDI platform