Individual
MS. CHARLENE A SMYTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 VALLEY DR, PARKSIDE CHILDREN'S CENTER, SYRACUSE, NY 13207-2298
(315) 468-1632
(315) 468-1635
Mailing address
209 BOULDER RD, SOLVAY, NY 13209-1713
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
307746031
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598996571
PARKSIDE CHILDREN'S CENTER
NY
Enumeration date
12/22/2010
Last updated
12/22/2010
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