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Individual

DR. STEPHEN SMIRLOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1000 HIGH ST, PORT CHESTER, NY 10573-4402
(917) 747-1749
(718) 724-1889
Mailing address
136A SUNFLOWER DR, LAKEWOOD, NJ 08701-2461
(917) 747-1749
(718) 724-1889

Taxonomy

Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
25MD00166100
NJ
213ES0131X
Foot Surgery Podiatrist
Primary
N0022322
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00413369
NY
05
8828369
NJ
Enumeration date
06/13/2006
Last updated
01/19/2021
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