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NPI Code Detail

MEDICARE: ELIZABETH MARY SMITH NP

MEDICARE: ELIZABETH MARY SMITH NP
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
1363LF0000XFamily Nurse Practitioner344615NY
2363LF0000XFamily Nurse PractitionerF344615-01NY

General Provider Information

NPI Number : 1346899812
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH MARY SMITH NP
Provider Business Mailing Address
First Line : 2515 SAINT PAUL BLVD
Second Line :
City : ROCHESTER
State : NY
Zip : 14617-4515
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 500 HAHNEMANN TRL
Second Line :
City : PITTSFORD
State : NY
Zip : 14534-2356
Country : US
Telephone Number : 585-586-7600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2019
Last Update Date : 07/03/2023

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