Individual
MS. LORI SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
169 RIVERSIDE DR, BINGHAMTON, NY 13905-4246
(607) 798-5220
Mailing address
169 RIVERSIDE DR, BINGHAMTON, NY 13905-4246
(607) 798-5220
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
004091
NY
Other
Enumeration date
11/28/2006
Last updated
07/08/2007
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