Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 3994 | NY |
NPI | 1144360017 |
---|---|
Provider Name | Dr. Lori M Smatt |
First Address | Pleasantville, NY 10570-1021 |
Second Address | Pleasantville, NY 10570-1021 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2007 |
Last Update Date | 06/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U70813 | (02) | NY |