Provider Demographics
NPI:1962240051
Name:SMITH, SHANAYA C
Entity type:Individual
Prefix:
First Name:SHANAYA
Middle Name:C
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 1:32500 MONROE CT APT 107B
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-5761
Mailing Address - Country:US
Mailing Address - Phone:216-471-0557
Mailing Address - Fax:
Practice Address - Street 1:32500 MONROE CT APT 107B
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-5761
Practice Address - Country:US
Practice Address - Phone:216-471-0557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)