Provider Demographics
NPI:1235999517
Name:SMITH, VERNELL (PESTICIDE APPLICATOR)
Entity Type:Individual
Prefix:MS
First Name:VERNELL
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:PESTICIDE APPLICATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 BUENA VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07506-2920
Mailing Address - Country:US
Mailing Address - Phone:201-494-2380
Mailing Address - Fax:973-843-1136
Practice Address - Street 1:153 BUENA VISTA AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NJ
Practice Address - Zip Code:07506-2920
Practice Address - Country:US
Practice Address - Phone:862-684-3959
Practice Address - Fax:973-843-1136
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ53686B171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications