Individual
STACEY L SMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
70 CORNWELL DR, BRIDGETON, NJ 08302-3602
(856) 455-6770
(856) 455-6030
Mailing address
51 BUCKHORN RD, SALEM, NJ 08079-9302
(856) 455-6770
(856) 455-6030
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00066000
NJ
Other
Enumeration date
08/09/2005
Last updated
02/12/2020
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