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Ty Smith Nurse Practitioner Adult
Primary Care Clinic/Center in Valley Stream, New York
NPI 1912788613

Ty Smith Nurse Practitioner Adult is a Primary Care Clinic/Center based in Valley Stream, NY and is specialized in Primary Care. Ty Smith Nurse Practitioner Adult practices in Valley Stream, NY. The NPI Number for Ty Smith Nurse Practitioner Adult is 1912788613 and holds a License No. (New York).

The current practice location address for Ty Smith Nurse Practitioner Adult is 76 S Central Ave Ste 1A, Valley Stream, NY and can be reached out via phone at 516-770-6102. You can also correspond with Ty Smith Nurse Practitioner Adult through the mailing address at 1595 N CENTRAL AVE APT 39, VALLEY STREAM, NY - 11580-1186 (mailing address contact number: 516-770-6102).

Location: 76 S Central Ave Ste 1A, Valley Stream, NY, 11580-1186
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1912788613
Provider Name
Ty Smith Nurse Practitioner Adult
Credential
Provider Entity Type
Organization
Address
76 S Central Ave Ste 1A, Valley Stream, NY, 11580-1186
Phone Number
516-770-6102
Fax Number
Provider Enumeration Date
10/09/2023
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
76 S Central Ave Ste 1A
City
Valley Stream
State
New York
Zip
11580-5405
Phone Number
516-770-6102
Fax Number
person
Provider Business Mailing Address Details
Address
1595 N Central Ave Apt 39
City
Valley Stream
State
New York
Zip
11580-1186
Phone Number
516-770-6102
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Health Service
Taxonomy
261QH0100X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
()
Definition
Definition to come...
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