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General NPI Number Information
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NPI Number | 1710713201
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Entity Type | Individual
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Provider Name | RAEGEN SMYTHE
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Gender | Female
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Dates
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Enumeration Date | 09/11/2024
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 7309 SENECA RD N
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City | HORNELL
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State | NY
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Zip | 14843-9691
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Country | US
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Telephone | 607-282-5200
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Fax | 585-335-5061
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Provider Business Mailing Address
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Address Line | 4612 MILLENNIUM DR
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City | GENESEO
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State | NY
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Zip | 14454-1197
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Country | US
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Telephone | 585-443-2018
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Fax | 585-991-5013
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 326977-01
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License Number State | NY
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