MEDICARE: DR. BARBARA D'AMICO SMITH PH.D.

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
1	103TC0700X	Clinical Psychologist	010995-1	NY

General Provider Information

NPI Number	:	1457304107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBARA D'AMICO SMITH PH.D.

Provider Business Mailing Address
First Line	:	162 MAIN ST
Second Line	:
City	:	COLD SPRING
State	:	NY
Zip	:	10516-2815
Country	:	US
Telephone Number	:	845-265-4338
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 ALBANY POST RD
Second Line	:
City	:	MONTROSE
State	:	NY
Zip	:	10548-1415
Country	:	US
Telephone Number	:	914-737-4400
Fax Number	:	914-788-4268

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	07/25/2008

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