Individual
KYLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4901 LAC DE VILLE BLVD., BLDG D, SUITE 250, ROCHESTER, NY 14618-5649
(585) 275-5321
Mailing address
601 ELMWOOD AVE BOX 664, ROCHESTER, NY 14642-0001
(585) 276-8394
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
315062
NY
2084P0804X
Child & Adolescent Psychiatry Physician
315062
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2018
Last updated
07/17/2023
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