Provider Demographics
NPI:1164405346
Name:SMITH, MARGARET STEPHENS (PA-C)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:STEPHENS
Last Name:SMITH
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1772 HELDERBERG TRL
Mailing Address - Street 2:
Mailing Address - City:BERNE
Mailing Address - State:NY
Mailing Address - Zip Code:12023-2709
Mailing Address - Country:US
Mailing Address - Phone:518-872-9262
Mailing Address - Fax:518-872-9265
Practice Address - Street 1:1772 HELDERBERG TRL
Practice Address - Street 2:
Practice Address - City:BERNE
Practice Address - State:NY
Practice Address - Zip Code:12023-2709
Practice Address - Country:US
Practice Address - Phone:518-872-9262
Practice Address - Fax:518-872-9265
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002280363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical