Basic Information
| Provider Information | |||||||||
| NPI: | 1790923944 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SMIT | ||||||||
| FirstName: | PIETER | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 150 55TH ST | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112202508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186307000 | ||||||||
| FaxNumber: | 7186308515 | ||||||||
| Practice Location | |||||||||
| Address1: | 88 E NEWTON ST | ||||||||
| Address2: | C515 | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021182308 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176388442 | ||||||||
| FaxNumber: | 6176388409 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2009 | ||||||||
| LastUpdateDate: | 01/26/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0102X | 268385 | NY | Y | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care |
No ID Information.