Provider Demographics
NPI:1518391044
Name:SMOKLER, JENNIFER IVY (MSED)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:IVY
Last Name:SMOKLER
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E 83RD ST
Mailing Address - Street 2:APT 8L
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-7208
Mailing Address - Country:US
Mailing Address - Phone:914-815-0130
Mailing Address - Fax:
Practice Address - Street 1:500 E 83RD ST
Practice Address - Street 2:APT 8L
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-7208
Practice Address - Country:US
Practice Address - Phone:914-815-0130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY757513131222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist