Provider Demographics
NPI:1598527269
Name:SMITH, NISHKA MARIE (NP)
Entity Type:Individual
Prefix:
First Name:NISHKA
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:681 STANTON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-1825
Mailing Address - Country:US
Mailing Address - Phone:646-334-8290
Mailing Address - Fax:
Practice Address - Street 1:681 STANTON AVE
Practice Address - Street 2:
Practice Address - City:NORTH BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-1825
Practice Address - Country:US
Practice Address - Phone:646-334-8290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program