Individual
DOREEN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
165 PLANK RD, COXSACKIE, NY 12051-2617
(518) 731-2741
Mailing address
30 PINE KNOB DR, ALBANY, NY 12203-5218
(518) 937-3073
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
199452
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10010842
CDPHP
NY
01
—
78O623
BLUE CROSS
NY
Enumeration date
03/29/2007
Last updated
03/05/2015
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