Individual
CARL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
764 E 176TH ST, BRONX, NY 10460-4606
(718) 542-8770
Mailing address
1575 TOWNSEND AVE APT 33, BRONX, NY 10452-6072
(718) 542-8770
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
22991
NY
Other
Enumeration date
04/19/2017
Last updated
04/19/2017
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