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Individual
STACEYANN SMITH
Active
Individual
STACEYANN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., MPH
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
294338
NY
390200000X
Student in an Organized Health Care Education/Training Program
MT209229
PA
Other
Enumeration date
06/04/2015
Last updated
07/15/2019
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