| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MEREDITH SMITH | 1457949976 | 2021-01-10 |
| Entity Type | Individual |
| Provider Name | Meredith Smith |
| Practice Office Address | 575 8TH AVE FL 6 NEW YORK, NY US |
| Practice Office Telephone | 9172865206 |
| Mailing Address | 15 MARYETTA CT SYOSSET, NY 117912517 US |
| Business Telephone | 5163049019 |
| Code | License No | State |
|---|---|---|
| 235Z00000X PRIMARY |