MEDICARE: DR. LORI MICHELE STORCH SMITH MD

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
1	2080A0000X	Pediatric Adolescent Medicine Physician	037656	CT

General Provider Information

NPI Number	:	1205834199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORI MICHELE STORCH SMITH MD

Provider Business Mailing Address
First Line	:	156 KINGS HWY NORTH
Second Line	:
City	:	WESTPORT
State	:	CT
Zip	:	06880-2400
Country	:	US
Telephone Number	:	203-227-3674
Fax Number	:	203-454-5639

Provider Business Practice Location Address
First Line	:	156 KINGS HWY NORTH
Second Line	:
City	:	WESTPORT
State	:	CT
Zip	:	06880-2400
Country	:	US
Telephone Number	:	203-227-3674
Fax Number	:	203-454-5639

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	02/26/2025

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