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Individual

MRS. SUZANNE C. SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN BSN NCSN

Contact information

Practice address
215 SOUTH BROAD STREET, SACKETS HARBOR, NY 13685-0290
(315) 646-3419
(315) 646-1038
Mailing address
215 SOUTH BROAD STREET, SACKETS HARBOR, NY 13685-0290
(315) 646-3419
(315) 646-1038

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
274339-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1013045327
NY
Enumeration date
03/09/2011
Last updated
03/09/2011
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