Individual
COLLEEN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
265 BROADHOLLOW RD STE 200, MELVILLE, NY 11747-4833
(888) 722-2072
Mailing address
11 WREN CT, NORTHPORT, NY 11768-3343
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
519354
NY
Other
Enumeration date
02/10/2026
Last updated
02/10/2026
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