MEDICARE: MRS. NANCY SMAHL-SYROP OTR

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	390200000X	Student in an Organized Health Care Education/Training Program	003180	NY

General Provider Information

NPI Number	:	1568615458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NANCY SMAHL-SYROP OTR

Provider Business Mailing Address
First Line	:	36 ALDRIDGE RD
Second Line	:
City	:	CHAPPAQUA
State	:	NY
Zip	:	10514-3401
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	36 ALDRIDGE RD
Second Line	:
City	:	CHAPPAQUA
State	:	NY
Zip	:	10514-3401
Country	:	US
Telephone Number	:	914-238-0142
Fax Number	:

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

Provider Enumeration Date	:	10/23/2008
Last Update Date	:	10/23/2008

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