Provider Demographics
NPI:1134289614
Name:SMITH, NANCY C (DC)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:C
Last Name:SMITH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LACKAWANNA PLACE
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960
Mailing Address - Country:US
Mailing Address - Phone:973-267-7744
Mailing Address - Fax:973-267-0581
Practice Address - Street 1:1 LACKAWANNA PLACE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960
Practice Address - Country:US
Practice Address - Phone:973-267-7744
Practice Address - Fax:973-267-0581
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC03209111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T92334Medicare UPIN
NJ598299Medicare PIN