Provider Demographics
NPI:1013622422
Name:SMITH, KAYLEIGH REY
Entity Type:Individual
Prefix:
First Name:KAYLEIGH
Middle Name:REY
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 1:99 RIGGS PL
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-5211
Mailing Address - Country:US
Mailing Address - Phone:973-440-7611
Mailing Address - Fax:
Practice Address - Street 1:99 RIGGS PL
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-5211
Practice Address - Country:US
Practice Address - Phone:973-440-7611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide