MEDICARE: ALFORD A SMITH MD PC

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	207Q00000X	Family Medicine Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1245603398
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALFORD A SMITH MD PC

Provider Business Mailing Address
First Line	:	PO BOX 150379
Second Line	:
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-0379
Country	:	US
Telephone Number	:	917-763-6721
Fax Number	:	347-561-6170

Provider Business Practice Location Address
First Line	:	765 NOSTRAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11216-4203
Country	:	US
Telephone Number	:	718-282-1570
Fax Number	:	347-561-6170

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALFORD ALEXANDER SMITH
Credential	:	M.D.
Telephone Number	:	917-763-6721

Provider Enumeration Date	:	11/10/2015
Last Update Date	:	12/10/2015

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