Provider Demographics
NPI:1386227874
Name:SMITH, BRITTANY MARIE (PHARM D)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 BELMONT ST
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:NY
Mailing Address - Zip Code:14715-1201
Mailing Address - Country:US
Mailing Address - Phone:716-378-5568
Mailing Address - Fax:
Practice Address - Street 1:2 CENTER ST
Practice Address - Street 2:
Practice Address - City:CUBA
Practice Address - State:NY
Practice Address - Zip Code:14727-1000
Practice Address - Country:US
Practice Address - Phone:585-968-3111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060473183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY060473OtherNYS PHARMACIST LICENSE NUMBER