Individual
MONTANNA J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PNP
Contact information
Practice address
6711 TOWPATH RD, EAST SYRACUSE, NY 13057-9510
(315) 471-2646
Mailing address
6711 TOWPATH RD, EAST SYRACUSE, NY 13057-9510
(315) 471-2646
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
Primary
750435
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
383826
NY
Other
Enumeration date
06/17/2024
Last updated
02/25/2026
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