Provider Demographics
NPI:1699519843
Name:SMITH, AMIRA SHEREEK
Entity type:Individual
Prefix:
First Name:AMIRA
Middle Name:SHEREEK
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 JOHNSON AVE
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-6025
Mailing Address - Country:US
Mailing Address - Phone:678-549-7080
Mailing Address - Fax:
Practice Address - Street 1:50 CHURCH ST
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2772
Practice Address - Country:US
Practice Address - Phone:678-549-7080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-22
Last Update Date:2024-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula