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NPI Code Detail

MEDICARE: ALLISA J SMITH

MEDICARE: ALLISA J SMITH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist028227NY

General Provider Information

NPI Number : 1104788660
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISA J SMITH
Provider Business Mailing Address
First Line : 387 ADAM ST
Second Line :
City : TONAWANDA
State : NY
Zip : 14150-1903
Country : US
Telephone Number : 716-471-8962
Fax Number :
Provider Business Practice Location Address
First Line : 200 7TH ST
Second Line :
City : BUFFALO
State : NY
Zip : 14201-2161
Country : US
Telephone Number : 716-847-2500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2025
Last Update Date : 12/02/2025

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Directions to “ ALLISA J SMITH ” Practice Location

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