Individual
CONNOR MATTINGLY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RRA
Contact information
Practice address
101 HOSPITAL RD, PATCHOGUE, NY 11772-4870
(631) 654-7100
Mailing address
65 MEADOWOODS LN APT 6, MORICHES, NY 11955-2002
(518) 960-0209
Taxonomy
Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
Primary
000269
NY
Other
Enumeration date
04/07/2025
Last updated
04/07/2025
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