Provider Demographics
NPI:1447569686
Name:SMYTH, EILEEN (RN)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:SMYTH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:FLORIDA
Mailing Address - State:NY
Mailing Address - Zip Code:10921-1826
Mailing Address - Country:US
Mailing Address - Phone:845-651-0582
Mailing Address - Fax:
Practice Address - Street 1:700 CORPORATE BLVD
Practice Address - Street 2:WILLCARE
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-6416
Practice Address - Country:US
Practice Address - Phone:845-561-3655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-06
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY508089163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse