Healthcare Provider Details

I. General information

NPI: 1376548149
Provider Name (Legal Business Name): LUCIAN SZMYD JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 05/11/2020
Certification Date: 05/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 BORTHWICK AVE SUITE 200 EAST
PORTSMOUTH NH
03801-7156
US

IV. Provider business mailing address

155 BORTHWICK AVE SUITE 200 EAST
PORTSMOUTH NH
03801-7156
US

V. Phone/Fax

Practice location:
  • Phone: 603-436-1773
  • Fax: 603-427-0655
Mailing address:
  • Phone: 603-436-1773
  • Fax: 603-427-0655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number7371
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number7371
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: