Individual
CHARISSE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
11 MADISON AVE, NEW YORK, NY 10010-3643
(212) 538-7770
(212) 656-1780
Mailing address
11 MADISON AVE, NEW YORK, NY 10010-3643
(212) 538-7770
(212) 656-1780
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
25MP00701600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02831643
—
NY
01
—
P00330253
RAILROAD
—
Enumeration date
03/22/2006
Last updated
06/02/2026
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