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NPI Code Detail

MEDICARE: ANNE SMITH M.D.

MEDICARE: ANNE SMITH M.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
12084P0800XPsychiatry Physician258405NY

General Provider Information

NPI Number : 1588676514
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNE SMITH M.D.
Provider Business Mailing Address
First Line : 1111 ELMWOOD AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14620-3005
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1111 ELMWOOD AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14620-3005
Country : US
Telephone Number : 585-241-1200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2006
Last Update Date : 05/31/2016

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