Provider Demographics
NPI:1376504415
Name:SMOTKIN, JOSEPH (MD)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:SMOTKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6-05 SADDLE RIVER RD # 138
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-5610
Mailing Address - Country:US
Mailing Address - Phone:201-787-7108
Mailing Address - Fax:
Practice Address - Street 1:6-05 SADDLE RIVER RD # 138
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-5610
Practice Address - Country:US
Practice Address - Phone:201-787-7108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60 246381208M00000X
NHLT2566208M00000X
NJ25MA07764200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH020470410OtherTAX ID
NH30206961Medicaid
ME432640099Medicaid
NH000241301OtherMEDICARE ID