MEDICARE: RONE' SMITH RN

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	163WA0400X	Addiction (Substance Use Disorder) Registered Nurse	977153	NY

General Provider Information

NPI Number	:	1619825502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONE' SMITH RN

Provider Business Mailing Address
First Line	:	306 NEW TERRACE LN
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14624-3771
Country	:	US
Telephone Number	:	585-317-6539
Fax Number	:

Provider Business Practice Location Address
First Line	:	1850 BRIGHTON HENRIETTA TOWN LINE RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14623-2532
Country	:	US
Telephone Number	:	585-287-5622
Fax Number	:

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

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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