Individual
JUSTIN KERRY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
223 N VAN DIEN AVE, RIDGEWOOD, NJ 07450-2726
(201) 847-9320
(201) 847-0059
Mailing address
PO BOX 630, FRANKLIN LAKES, NJ 07417-0630
(201) 847-9320
(201) 847-0059
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA10297300
NJ
Other
Enumeration date
04/10/2014
Last updated
04/23/2018
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