Individual
SHANELL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
772 E 223RD ST, BRONX, NY 10466
(347) 843-0444
Mailing address
10534 REMINGTON ST, JAMAICA, NY 11435-5010
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
810372
NY
164W00000X
Licensed Practical Nurse
333752
NY
Other
Enumeration date
10/23/2019
Last updated
03/18/2021
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