Smith, Roberta

Smith, Roberta is an individual health care provider with primary practice located at 333 Cottman Ave , Philadelphia PA 19111-2434. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Smith, Roberta can be contacted via phone (215) 728-3675.

Contact Information

Primary practice address
333 Cottman Ave Philadelphia PA 19111-2434
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X MD05004674L Pennsylvania

Profile Details

NPI number 1396700191
LBN Legal business name Smith, Roberta
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2006
Last updated Apr 12th, 2018 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396700191 NPPES
Pennsylvania MEDICAID 0015097230005

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