Provider Demographics
NPI:1669583779
Name:SMITH, ROBERT LYNN (MD)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:LYNN
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:23 NORTH STREET
Mailing Address - Street 2:SUITE 5
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424
Mailing Address - Country:US
Mailing Address - Phone:585-394-8170
Mailing Address - Fax:585-348-2020
Practice Address - Street 1:23 NORTH STREET
Practice Address - Street 2:SUITE 5
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424
Practice Address - Country:US
Practice Address - Phone:585-394-8170
Practice Address - Fax:585-348-2020
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2024-04-18
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Provider Licenses
StateLicense IDTaxonomies
NY224291207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02383457Medicaid
NYRA9341Medicare PIN
NYH81697Medicare UPIN