Smith, Kelly M
Smith, Kelly M is an individual health care provider with primary practice located at 213 Main Street Salem Family Health Center, Salem NY 12865. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Smith, Kelly M can be contacted via phone (518) 854-3821.Contact Information
Primary practice address
213 Main Street Salem Family Health Center
Salem NY 12865
Phone: (518) 854-3821
Fax: (518) 854-3224
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 003117 | New York |
Profile Details
| NPI number | 1194818658 |
|---|---|
| LBN Legal business name | Smith, Kelly M |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 2nd, 2006 |
| Last updated | Jun 7th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194818658 | NPPES |
| New York | MEDICAID | 01599751 |
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