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
Phone: (215) 728-3675
Fax:
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1396700191 | NPPES |
Pennsylvania | MEDICAID | 0015097230005 |
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