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NPI Code Detail

MEDICARE: CARLA SMITH-RICKS PA-C

MEDICARE:   CARLA  SMITH-RICKS  PA-C
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
1363AM0700XMedical Physician Assistant009881NY

General Provider Information

NPI Number : 1902096746
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLA SMITH-RICKS PA-C
Provider Business Mailing Address
First Line : 157 EAST 18TH STREET
Second Line : GROUND FLOOR
City : NEW YORK
State : NY
Zip : 10003
Country : US
Telephone Number : 212-260-6078
Fax Number : 212-477-3575
Provider Business Practice Location Address
First Line : 157 E 18TH ST
Second Line : GROUND FLOOR
City : NEW YORK
State : NY
Zip : 10003-2409
Country : US
Telephone Number : 212-260-6078
Fax Number : 212-477-3575
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2007
Last Update Date : 07/27/2007

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Directions to “ CARLA SMITH-RICKS PA-C” Practice Location

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