Individual
REGINALD SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3584 JEROME AVE, BRONX, NY 10467-1006
(718) 653-1537
(718) 228-6993
Mailing address
1158 COLGATE AVE APT 4A, BRONX, NY 10472-3150
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
32359
NY
Other
Enumeration date
01/19/2022
Last updated
01/06/2023
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