Active NPI
Dezna Jacqueline Smikle, BS
- Medical Technologist
- Bronx, NY
National Provider Identifier
1629194154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Technologist
- License
- 007431
- Practice address
- 234 E 149TH St
Bronx, NY 10451-5504 - Phone
- (718) 579-5332
- NPI assigned
- Mar 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Technologist | 246QM0706X | 007431 | NY | Primary |
Addresses
Primary practice location
234 E 149TH St
Bronx, NY 10451-5504
Mailing address
1052 E 229TH St
Bronx, NY 10466-4808
Phone (718) 881-2819
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629194154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1052 E 229TH ST",
"city": "BRONX",
"state": "NY",
"postal_code": "104664808",
"telephone_number": "718-881-2819",
"fax_number": "718-881-2819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "234 E 149TH ST",
"city": "BRONX",
"state": "NY",
"postal_code": "104515504",
"telephone_number": "718-579-5332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMIKLE",
"first_name": "DEZNA",
"middle_name": "JACQUELINE",
"name_prefix": "Mrs.",
"credential": "BS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "246QM0706X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Pathology, Medical Technologist",
"state": "NY",
"license": "007431",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.