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Individual

MR. DAVIOT IAN CLUNES SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.N

Contact information

Practice address
272 MACDONOUGH ST, BROOKLYN, NY 11233-1007
(718) 573-4206
Mailing address
272 MACDONOUGH ST, BROOKLYN, NY 11233-1007
(718) 573-4206

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
466897
NY

Other

Enumeration date
03/30/2012
Last updated
03/30/2012
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