Provider Demographics
NPI:1760948194
Name:SMITH, BARBARA J
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:WYNANTSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12198-0219
Mailing Address - Country:US
Mailing Address - Phone:518-283-6500
Mailing Address - Fax:518-283-0524
Practice Address - Street 1:614 COOPER HILL RD
Practice Address - Street 2:
Practice Address - City:WYNANTSKILL
Practice Address - State:NY
Practice Address - Zip Code:12198-2906
Practice Address - Country:US
Practice Address - Phone:518-283-6500
Practice Address - Fax:518-283-6500
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY266426163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse