Provider Demographics
NPI:1447612908
Name:SMITH, MELANIE HENNEBRY (MD, PHD)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:HENNEBRY
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:535 EAST 70TH STREET
Mailing Address - Street 2:DEPT. OF RHEUMATOLOGY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4898
Mailing Address - Country:US
Mailing Address - Phone:212-774-2189
Mailing Address - Fax:212-774-2295
Practice Address - Street 1:535 EAST 70TH STREET
Practice Address - Street 2:DEPT. OF RHEUMATOLOGY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4898
Practice Address - Country:US
Practice Address - Phone:212-774-2189
Practice Address - Fax:212-774-2295
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY290763390200000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program