Dr. Charles Joseph Smutny III
Sports Medicine Doctor General Practice Physician Neuromusculoskeletal Medicine (NMM)
717 Larkfield Rd
Commack
, New York 11725-2600
Dr. Charles Joseph Smutny III
Sports Medicine Doctor General Practice Physician Neuromusculoskeletal Medicine (NMM)
717 Larkfield Rd
Commack
, New York 11725-2600
(631) 486-4722
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About
Features
Specialties
- Sports Medicine Doctor
- Neuromusculoskeletal Medicine (NMM)
- General Practice Physician
Languages spoken
- English
Location
First Address
- Dr. Charles Joseph Smutny III
- 717 Larkfield Rd
- Commack, NY
- Zip : 11725-2600
- Fax : (631) 486-4722
- Phone : (631) 486-4720
Second Address
- Dr. Charles Joseph Smutny III
- 717 Larkfield Rd
- Commack, NY
- Zip : 11725-2600
- Fax : (631) 486-4722
- Phone : (631) 486-4720
Reviews
FAQs
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What type of doctor is Dr. Charles Joseph Smutny III
In what state does Dr. Charles Joseph Smutny III practice in?
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What is Dr. Charles Joseph Smutny III’s gender?
Is Dr. Charles Joseph Smutny III a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 204C00000X | Sports Medicine Doctor | 206232 | NY |
| Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 206232 | NY |
| N | 208D00000X | General Practice Physician | 206232 | NY |
National Provider Identifier
| NPI | 1912962473 |
|---|---|
| Provider Name | Dr. Charles Joseph Smutny III |
| First Address | Commack, NY 11725-2600 |
| Second Address | Commack, NY 11725-2600 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/04/2006 |
| Last Update Date | 04/09/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 01V30EN311 | MEDICARE INTERUM INDIVPIN (01) | NY |
| 01V30EN311 | MEDICARE PTAN (01) | NY |
| 1639358799 | GROUP NPI (01) | NY |
| 1912962473 | INDIVIDUAL NPI (01) | NY |
| 206232 | NY STATE LICENSE # (01) | NY |
| 62296658 | INDIVIDUAL MEDICARE PIN (01) | NY |
| G5906 | (02) | NY |
| WEN311 | MEDICARE GROUP PIN (01) | NY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.