Provider Demographics
NPI:1437508207
Name:SMART, CAITLIN R (CPNP)
Entity Type:Individual
Prefix:MS
First Name:CAITLIN
Middle Name:R
Last Name:SMART
Suffix:
Gender:F
Credentials:CPNP
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Mailing Address - Street 1:301 MANCHESTER RD.
Mailing Address - Street 2:SUITE 105
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-2587
Mailing Address - Country:US
Mailing Address - Phone:845-452-1700
Mailing Address - Fax:845-452-1752
Practice Address - Street 1:301 MANCHESTER RD.
Practice Address - Street 2:SUITE 105
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-2587
Practice Address - Country:US
Practice Address - Phone:845-452-1700
Practice Address - Fax:845-452-1752
Is Sole Proprietor?:No
Enumeration Date:2016-06-12
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY704510-1163W00000X
NYF382734-1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse