Most Relevant Information
Provider Data
| NPI Number: | 1003378068 |
| Provider Name: | RAEGAN M SMITH RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 758652 |
Most Important Dates
| Enumeration Date: | 04/01/2019 |
| Last Updated: | 04/01/2019 |
Provider Practice Location
52 LAUREL CT
WADING RIVER
NY
117921035
Practice Location Phone/Fax
| Phone: | 6319215594 |
| Fax: |
Provider Mailing Location
52 LAUREL CT
WADING RIVER
NY
117921035
Provider Mailing Phone/Fax
| Phone: | 6319215594 |
| Fax: |