Thotam, Smitha Mary

Thotam, Smitha Mary is an individual health care provider with primary practice located at 280 E Main St , Bay Shore NY 11706-8403. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Thotam, Smitha Mary can be contacted via phone (631) 666-3939.

Contact Information

Primary practice address
280 E Main St Bay Shore NY 11706-8403
Phone: (631) 666-3939
Fax: (631) 666-1860
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 506599 New York
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X F305772 New York

Profile Details

NPI number 1629262639
LBN Legal business name Thotam, Smitha Mary
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 3rd, 2007
Last updated Aug 4th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629262639 NPPES
New York MEDICAID 02877329

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