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1710360102
PETER SMITH
RIVERHEAD, NY
NPI
1710360102
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner Psychiatric/Mental Health
(Licence: NY 401875)
Enumeration Date
2015-07-02
Last Update Date
2016-04-06
Business Address
PETER SMITH NP
208 ROANOKE AVE
RIVERHEAD, NY 11901-2706
Phone number: 631-369-0104
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Mailing Address
PETER SMITH NP
208 ROANOKE AVE
RIVERHEAD, NY 11901-2706
Phone number: 631-369-0104
Copy
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