National Provider Identifier

Nicholas A Smith, PA

Nicholas A Smith, PA is listed in the NPPES registry with a primary specialty of Physician Assistant in Ithaca, NY and a listed phone number of (607) 274-4296.

NPI 1851069082Ithaca, NYPhysician Assistant

Profile Overview

NPI
1851069082
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
September 02, 2021
Last Updated
September 02, 2021

Practice Location

  • 101 Dates Dr
  • Ithaca, NY 14850-1342

Phone: (607) 274-4296

Mailing Address

  • 3361 N Shuler RD
  • Alpine, NY 14805-9740

Specialties

  • Physician Assistant (363A00000X)
Full Record
NPI
1851069082
Entity Type
Individual
Last Name
Smith
First Name
Nicholas
Middle Name
A
Name Prefix
Mr.
Credential
PA
Mailing Street Address
3361 N Shuler RD
Mailing City
Alpine
Mailing State
NY
Mailing ZIP Code
14805-9740
Mailing Country
US
Mailing Phone
(607) 703-9409
Practice Street Address
101 Dates Dr
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850-1342
Practice Country
US
Practice Phone
(607) 274-4296
Enumeration Date
September 02, 2021
Last Updated
September 02, 2021
Sex
Male
Sole Proprietor
No
Certification Date
September 02, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X)