| Doctor Name: | KAITLYN SMITH |
| NPI Number: | 1083034946 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 26NJ00498600 |
| Business Practice Address: | 765 Route 10 E Ste 201 Randolph, NJ - 078691925 |
| Business Phone Number: | 9734791128 |
| Business Fax Number: | |
| Mailing Address: | 105 Raider Blvd, Suite 101 HILLSBOROUGH |
| State: | NJ |
| Postal Code: | 088441528 |
| Phone Number: | 9734791129 |
| Fax Number: | |
| NPI Enumeration Date: | 04/18/2014 |
| NPI Last Update Date: | 03/25/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | 26NJ00498600 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |