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NPI Code Detail

MEDICARE: AMANDA SMITH-SOCARIS P.T.

MEDICARE: AMANDA SMITH-SOCARIS P.T.
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
12251X0800XOrthopedic Physical Therapist018951NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932191962
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA SMITH-SOCARIS P.T.
Provider Business Mailing Address
First Line : 609 N FRANKLIN ST
Second Line :
City : WATKINS GLEN
State : NY
Zip : 14891-1302
Country : US
Telephone Number : 607-535-7475
Fax Number : 607-535-7445
Provider Business Practice Location Address
First Line : 609 N FRANKLIN ST
Second Line :
City : WATKINS GLEN
State : NY
Zip : 14891-1302
Country : US
Telephone Number : 607-535-7475
Fax Number : 607-535-7445
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2005
Last Update Date : 09/03/2009

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