Individual
ELISA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
550 1ST AVE, NEW YORK, NY 10016-6402
(646) 929-7870
Mailing address
550 1ST AVE, NEW YORK, NY 10016-6402
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
020567
NY
Other
Enumeration date
01/26/2017
Last updated
08/05/2020
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