Provider Demographics
NPI:1386789303
Name:SMITH, JEFFERY STEVEN (MD)
Entity type:Individual
Prefix:
First Name:JEFFERY
Middle Name:STEVEN
Last Name:SMITH
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 1:260 GARTH RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-4051
Mailing Address - Country:US
Mailing Address - Phone:914-725-3901
Mailing Address - Fax:914-725-3963
Practice Address - Street 1:260 GARTH RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-4051
Practice Address - Country:US
Practice Address - Phone:914-725-3901
Practice Address - Fax:914-725-3963
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1166092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY321532Medicare UPIN