MEDICARE: DR. CECILIA M. SMITH D.O.

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	207RP1001X	Pulmonary Disease Physician	OS003829L	PA

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	:	1679576037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CECILIA M. SMITH D.O.

Provider Business Mailing Address
First Line	:	PO BOX 13579
Second Line	:
City	:	READING
State	:	PA
Zip	:	19612-3579
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	560 VAN REED RD
Second Line	:	SUITE 101
City	:	WYOMISSING
State	:	PA
Zip	:	19610-1799
Country	:	US
Telephone Number	:	484-628-4093
Fax Number	:	484-628-2526

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	10/06/2016

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