1427231133 NPI number — MISS SHERLETTE NADINE SMITH FNP

Table of content: MISS SHERLETTE NADINE SMITH FNP (NPI 1427231133)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427231133 NPI number — MISS SHERLETTE NADINE SMITH FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SMITH
Provider First Name:
SHERLETTE
Provider Middle Name:
NADINE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ELMORE
Provider Other First Name:
SHERLETTE
Provider Other Middle Name:
NADINE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1427231133
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/13/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
150 E 42ND ST FL 9
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10017-5699
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
646-605-8186
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 W 86TH ST APT 3B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10024-3625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-382-3801
Provider Business Practice Location Address Fax Number:
212-523-6075
Provider Enumeration Date:
12/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  F335377-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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