Individual
TAMARA Y SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
76 S CENTRAL AVE STE 1A, VALLEY STREAM, NY 11580-5405
(516) 284-7521
(516) 475-2600
Mailing address
1595 N CENTRAL AVE APT 39, VALLEY STREAM, NY 11580-1186
(516) 284-7521
(516) 475-2600
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
654591
NY
363LA2200X
Adult Health Nurse Practitioner
308468
NY
363LG0600X
Gerontology Nurse Practitioner
Primary
308468
NY
Other
Enumeration date
08/23/2017
Last updated
01/27/2024
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