Individual provider · Type 1 NPI
Alicia Tamara Portuondo-Smith, NURSE PRACTITIONER
Psychiatric/Mental Health Nurse Practitioner · Glen Head, NY
NPI number
1730400482
Active
Practice location
189 Wheatley Rd
Glen Head, NY 11545-2641
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 590004 (NY) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | F402195-1 (NY) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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Other psychiatric/mental health nurse practitioner providers in Glen Head
About NPI 1730400482
Alicia Tamara Portuondo-Smith, NURSE PRACTITIONER's National Provider Identifier is 1730400482, issued on Jun 17, 2010. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Glen Head, NY. The record was last updated on Dec 19, 2018.