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NPI Code Detail

MEDICARE: SELAH E SMITH

MEDICARE: SELAH E SMITH
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
1164W00000XLicensed Practical Nurse354274NY

General Provider Information

NPI Number : 1548192925
Entity Type Code : Individual
Provider Name (Legal Business Name) : SELAH E SMITH
Provider Business Mailing Address
First Line : 716 S JENSEN RD
Second Line :
City : VESTAL
State : NY
Zip : 13850-5404
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 249 GLENWOOD RD
Second Line :
City : BINGHAMTON
State : NY
Zip : 13905-1603
Country : US
Telephone Number : 315-474-5006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Practice Fax:

Directions to “ SELAH E SMITH ” Practice Location

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