Individual
MISS DOREEN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
300 E MAIN ST STE 2, SMITHTOWN, NY 11787-2900
(631) 780-6126
(631) 256-4844
Mailing address
10 OLD RIVERHEAD ROAD, WESTHAMPTON BEACH, NY 11946
(631) 369-4292
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
661228
NY
363LF0000X
Family Nurse Practitioner
Primary
342007
NY
Other
Enumeration date
05/23/2017
Last updated
11/27/2023
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