Individual
VICTORIA K SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
267 GRANT ST, BRIDGEPORT, CT 06610-2805
(203) 384-3000
Mailing address
75 RAILROAD AVE, APT 2K, MILFORD, CT 06460-9204
(218) 831-1173
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002666
CT
363A00000X
Physician Assistant
5923
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002666
PHYSICIAN ASSISTANT LICENSE
CT
Enumeration date
10/21/2011
Last updated
01/25/2022
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