Individual
DERRICK SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 2ND AVE, APT 2A, NEW YORK, NY 10003-8307
(609) 556-8345
Mailing address
100 2ND AVE, APT 2A, NEW YORK, NY 10003-8307
(609) 556-8345
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
603487
NY
Other
Enumeration date
06/03/2015
Last updated
06/03/2015
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