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1326388695
JOHANNA M SMITH
PORT JEFFERSON STATION, NY
NPI
1326388695
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: NY 306296)
Enumeration Date
2013-02-25
Last Update Date
2013-02-25
Business Address
-- JOHANNA M SMITH NP
410 HALLOCK AVE
PORT JEFFERSON STATION, NY 11776-1232
Phone number: 631-642-1100
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Mailing Address
-- JOHANNA M SMITH NP
2800 MARCUS AVE
NEW HYDE PARK, NY 11042-1113
Phone number: 516-622-6040
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