Individual
MRS. KAREN M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
24 STEVENS ST, NORWALK, CT 06850-3852
(203) 852-2609
(203) 852-3436
Mailing address
349 MAIN AVE, #6, NORWALK, CT 06851-1588
(607) 738-2597
(203) 852-3436
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
3368
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3368
CT STATE LICENSE
CT
Enumeration date
08/06/2015
Last updated
08/06/2015
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