Individual
BETHANY P. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
300 HOFFMAN ST, ELMIRA, NY 14905-2263
(607) 734-4110
(607) 734-0344
Mailing address
571 SAINT JOSEPHS BLVD FL 2, ELMIRA, NY 14901-3230
(607) 271-2050
(607) 873-1244
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
028868
NY
363A00000X
Physician Assistant
PA9109967
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100680300
—
FL
Enumeration date
10/26/2016
Last updated
11/15/2022
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