Individual ProviderAntwon SmithRegistered NurseNursing Service ProvidersPractice Address363 Highland Ave Ext, Middletown, NY 10940-4451(845) 341-8236PECOS EnrollmentBased on the most recent information from CMS, provider Antwon Smith does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1639628209Provider TypeIndividualFull NameSmith, AntwonCredentialRNGenderMaleSole ProprietorYesEnumeration Date9/23/2016Last Updated9/23/2016Contact InformationPractice LocationPractice Address363 Highland Ave Ext, Middletown, NY 10940-4451Phone(845) 341-8236FaxUnlisted FaxMailing LocationMailing Address363 Highland Ave Ext, Middletown, NY 10940-4451Phone(845) 341-8236FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense7198391New York