Provider Demographics
NPI:1447563374
Name:SMARDZ, JEFFREY FLOYD
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:FLOYD
Last Name:SMARDZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 KIRKGATE DR
Mailing Address - Street 2:
Mailing Address - City:SPENCERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14559-2175
Mailing Address - Country:US
Mailing Address - Phone:585-733-3939
Mailing Address - Fax:
Practice Address - Street 1:74 KIRKGATE DR
Practice Address - Street 2:
Practice Address - City:SPENCERPORT
Practice Address - State:NY
Practice Address - Zip Code:14559-2175
Practice Address - Country:US
Practice Address - Phone:585-733-3939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5213-1156FX1800X
FLDO 5656156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician