Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 215065 | NY |
NPI | 1114027893 |
---|---|
Provider Name | Richard F Smith |
First Address | Katonah, NY 10536-1505 |
Second Address | Katonah, NY 10536-1505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2006 |
Last Update Date | 24/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H13265 | (02) | NY |