Individual
SMITHA SIBY KURIAKOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
PARK AVENUE MEDICAL ASSOCIATES PC, THREE BARKER AVENUE 4TH FLOOR, WHITE PLAINS, NY 10601
(914) 949-1199
(914) 949-1245
Mailing address
PARK AVENUE MEDICAL ASSOCIATES PC, THREE BARKER AVENUE 4TH FLOOR, WHITE PLAINS, NY 10601
(914) 949-1199
(914) 949-1245
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
334385
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02655241
—
NY
01
—
P00252114
RAILROAD MEDICARE
NY
Enumeration date
07/17/2006
Last updated
07/08/2007
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