Individual
MS. EMILY TARA SMYTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
525 EAST 68TH ST, NEW YORK, NY 10065
(212) 746-5454
Mailing address
3172 31ST ST, APT 2L, ASTORIA, NY 11106-2581
(315) 436-3205
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
015018
NY
Other
Enumeration date
11/30/2011
Last updated
11/30/2011
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