Individual
KENISHA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1550 TOWNSEND AVE APT 6J, BRONX, NY 10452-6020
(646) 406-6788
Mailing address
85 W BURNSIDE AVE, BRONX, NY 10453-4015
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
341956
NY
Other
Enumeration date
07/13/2018
Last updated
03/04/2019
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