Doctor Name: | DR. MARTIN L SMITHLINE |
NPI Number: | 1306809660 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | |
Business Practice Address: | 44 Godwin Ave Midland Park, NJ - 074321969 |
Business Phone Number: | 2014475454 |
Business Fax Number: | 2014478922 |
Mailing Address: | 412 Drury Ln, WYCKOFF |
State: | NJ |
Postal Code: | 074812201 |
Phone Number: | 2014475454 |
Fax Number: | 2018916563 |
NPI Enumeration Date: | 04/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |