Provider Demographics
NPI:1831995497
Name:SMITH, ADRIAN L
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:L
Last Name:SMITH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19023-2832
Mailing Address - Country:US
Mailing Address - Phone:610-543-9271
Mailing Address - Fax:
Practice Address - Street 1:117 S 5TH ST
Practice Address - Street 2:
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-2832
Practice Address - Country:US
Practice Address - Phone:610-543-9271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care