Basic Information
| Provider Information | |||||||||
| NPI: | 1730142936 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SMINA | ||||||||
| FirstName: | MIHAI | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 143 HOYT ST | ||||||||
| Address2: | 3 H | ||||||||
| City: | STAMFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 069055759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184092222 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2016 BRONXDALE AVE | ||||||||
| Address2: | 301 | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104623388 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184092222 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | 001635-1 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 02395417 | 05 | NY | MEDICAID |