Individual
CHRISTOPHER SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
54 TUSCARORA DR, CENTERPORT, NY 11721-1553
(516) 448-5172
Mailing address
54 TUSCARORA DR, CENTERPORT, NY 11721-1553
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
014204
NY
174400000X
Specialist
014204
NY
Other
Enumeration date
01/24/2007
Last updated
08/12/2024
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