Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 204803 | NY |
NPI | 1205801982 |
---|---|
Provider Name | Dr. George P Smith |
First Address | Staten Island, NY 10314-3916 |
Second Address | Staten Island, NY 10314-3916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2006 |
Last Update Date | 17/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H34006 | (02) | NY |