Individual
MARYALICE P SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
79 CANARAS AVE, SARANAC LAKE, NY 12983-1560
(518) 897-1753
(518) 891-4675
Mailing address
34 TADDS WAY, SARANAC LAKE, NY 12983-2520
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
343700
NY
Other
Enumeration date
10/15/2012
Last updated
10/15/2012
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