Provider Demographics
NPI:1063482149
Name:SMITH, LINDA J (NP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:SMITH
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:571 SAINT JOSEPHS BLVD
Mailing Address - Street 2:FL 2
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-3230
Mailing Address - Country:US
Mailing Address - Phone:607-271-2050
Mailing Address - Fax:607-271-2099
Practice Address - Street 1:123 CONHOCTON ST STE 101
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-2959
Practice Address - Country:US
Practice Address - Phone:607-438-1200
Practice Address - Fax:607-438-1221
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2022-05-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY332249363L00000X, 363LC0200X
NYF332249-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01867981Medicaid
NYMS0373465OtherDEA
NYMS0373465OtherDEA
NYS59969Medicare UPIN