Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 192354 | NY |
N | 207KA0200X | Allergist | 192354 | NY |
Y | 207R00000X | Internist | 192354 | NY |
Y | 111NI0900X | Internist | 192354 | NY |
N | 207RA0201X | Internist - Allergy & Immunology | 192354 | NY |
NPI | 1962592147 |
---|---|
Provider Name | Kendall A Smith |
First Address | New York, NY 10021-4870 |
Second Address | New York, NY 10021-4870 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 14/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F74241 | (02) | NY |