Healthcare Provider Details

I. General information

NPI: 1053048090
Provider Name (Legal Business Name): ARLIAN SMITH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2022
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LONG WHARF DR
NEW HAVEN CT
06511-5991
US

IV. Provider business mailing address

1 LONG WHARF DR
NEW HAVEN CT
06511-5991
US

V. Phone/Fax

Practice location:
  • Phone: 203-688-8800
  • Fax:
Mailing address:
  • Phone: 410-933-6423
  • Fax: 410-500-4266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number5807
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0010167
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: