Individual
SUSAN O SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0002
(585) 275-7944
(585) 244-0502
Mailing address
601 ELMWOOD AVE, BOX 670, ROCHESTER, NY 14642-0001
(585) 275-7944
(585) 244-0502
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
443130
NY
363L00000X
Nurse Practitioner
Primary
301476
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02443209
—
NY
Enumeration date
07/11/2006
Last updated
07/05/2023
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