Provider Demographics
NPI:1992993513
Name:DR. MICHAEL C. SMATT
Entity type:Organization
Organization Name:DR. MICHAEL C. SMATT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:SMATT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:212-684-5811
Mailing Address - Street 1:295 MADISON AVE
Mailing Address - Street 2:SUITE 1709
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6304
Mailing Address - Country:US
Mailing Address - Phone:212-684-5811
Mailing Address - Fax:212-684-5813
Practice Address - Street 1:295 MADISON AVE
Practice Address - Street 2:SUITE 1709
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6304
Practice Address - Country:US
Practice Address - Phone:212-684-5811
Practice Address - Fax:212-684-5813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2875111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT75225Medicare UPIN
NYX16631Medicare PIN