Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 021066 | NY |
Y | 2251P0200X | Physical Therapist - Pediatrics | 021066 | NY |
NPI | 1124269337 |
---|---|
Provider Name | Adina M Smith |
First Address | Brooklyn, NY 11210-5311 |
Second Address | Brooklyn, NY 11210-5311 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2009 |
Last Update Date | 18/03/2009 |