Individual
SAMANTHA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35 LONGWOOD RD, MIDDLE ISLAND, NY 11953-2045
(631) 924-0008
Mailing address
PO BOX 12, MIDDLE ISLAND, NY 11953-0012
(631) 924-0008
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
457655886
NY
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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