DR. MARISSA M SMITH MD NPI 1427218833

NPI Information

NPI: 1427218833
Provider Name: DR. MARISSA M SMITH, MD
Classification:
Entity Type: Individual

PECOS Registration: Yes

Address:
4900 BROAD ROAD
SYRACUSE, NY
ZIP 13215
Phone: (315) 492-5437
Get Directions

DR. Marissa M Smith, MD is a healthcare provider in Syracuse, NY. DR. Marissa M Smith, MD NPI is 1427218833. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4900 BROAD ROAD
SYRACUSE, NY
ZIP 13215
Phone: (315) 492-5437
Fax: (315) 492-5502

The NPI 1427218833 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/10/2008 and was last updated on 11/3/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		050185	CONNECTICUT	No
2	2080S0010X	Pediatrics	Sports Medicine	050185	CONNECTICUT	No
3	208000000X	Pediatrics		275336	NEW YORK	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	03378998	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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