Individual
KAITLIN TERESA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
475 PROSPECT AVE STE 101, WEST ORANGE, NJ 07052-4197
(973) 325-2229
Mailing address
108 JACKSON ST APT 3C, HOBOKEN, NJ 07030-6101
(716) 982-7051
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
25MP00689900
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/14/2021
Last updated
04/12/2022
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