Individual
MR. BRANDON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, STUDENT NP
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-2000
Mailing address
17 REDWOOD LOOP, STATEN ISLAND, NY 10309-1654
(347) 996-9625
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
779775
NY
363LF0000X
Family Nurse Practitioner
Primary
350490
NY
Other
Enumeration date
04/14/2022
Last updated
10/03/2022
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