Provider Demographics
NPI:1184883357
Name:SMITH, LETTY CHANDRA (MD)
Entity type:Individual
Prefix:
First Name:LETTY
Middle Name:CHANDRA
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:STONY BROOK UNIVERSITY HOSPITAL
Mailing Address - Street 2:DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL SCIENCES
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8101
Mailing Address - Country:US
Mailing Address - Phone:631-444-3005
Mailing Address - Fax:631-444-7534
Practice Address - Street 1:201 MANOR PL
Practice Address - Street 2:EASTERN LONG ISLAND HOSPITAL
Practice Address - City:GREENPORT
Practice Address - State:NY
Practice Address - Zip Code:11944-1222
Practice Address - Country:US
Practice Address - Phone:631-477-1000
Practice Address - Fax:631-477-8108
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2012-06-10
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Provider Licenses
StateLicense IDTaxonomies
NY2653612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry