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Individual

KRISTA M SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2655 RIDGEWAY AVE, SUITE 440, ROCHESTER, NY 14626-4296
(585) 723-7705
(585) 368-3219
Mailing address
2655 RIDGEWAY AVE, SUITE 440, ROCHESTER, NY 14626-4296
(585) 723-7705
(585) 368-3219

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
020496
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04738863
NY
Enumeration date
09/14/2009
Last updated
07/06/2017
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