Individual
KENNETH C. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV005868-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02151302
—
NY
01
—
1561736
CIGNA
NY
01
—
18216P
HIP
NY
01
—
3750977
AETNA HMO
NY
01
—
6599281
GHI
NY
01
—
6C0858
HEALTHNET
NY
01
—
7652507
AETNA PPO/EPO
NY
01
—
C367E1
EMPIRE BLUE CROSS BLUE SH
NY
01
—
P2929150
OXFORD HEALTH PLAN
NY
Enumeration date
02/13/2006
Last updated
06/26/2025
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