Provider Demographics
NPI:1376504415
Name:SMOTKIN, JOSEPH (MD)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:SMOTKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 DUBOIS ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550
Mailing Address - Country:US
Mailing Address - Phone:845-561-4400
Mailing Address - Fax:845-568-2851
Practice Address - Street 1:70 DUBOIS ST
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550
Practice Address - Country:US
Practice Address - Phone:845-561-4400
Practice Address - Fax:845-568-2851
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07764200207R00000X
NHLT2566208M00000X
NY60 246381208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30206961Medicaid
NJ087021TN1Medicare ID - Type Unspecified
NJI23461Medicare UPIN