Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0203X | Pediatric Critical Care Doctor | 2006-00509 | NC |
Y | 2080P0203X | Pediatric Critical Care Doctor | MD431657 | PA |
NPI | 1154361491 |
---|---|
Provider Name | Dr. Rebecca L Smith |
First Address | Lemoyne, PA 17043-1168 |
Second Address | Lemoyne, PA 17043-1168 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 07/01/2022 |