Provider Demographics
NPI:1609904796
Name:SMITH, ANDREW NORMAN (ATC)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:NORMAN
Last Name:SMITH
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 CHASSIN AVE
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4203
Mailing Address - Country:US
Mailing Address - Phone:716-888-3167
Mailing Address - Fax:716-888-2881
Practice Address - Street 1:42 CHASSIN AVE
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-4203
Practice Address - Country:US
Practice Address - Phone:716-888-3167
Practice Address - Fax:716-888-2881
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer