Individual
ELLEN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 SUMMIT AVE, MONTVALE, NJ 07645-1523
(201) 650-6798
Mailing address
225 SUMMIT AVE, MONTVALE, NJ 07645-1523
(201) 650-6798
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ01019000
NJ
Other
Enumeration date
01/21/2019
Last updated
07/25/2022
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