Basic Information
| Provider Information | |||||||||
| NPI: | 1316994312 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SMITH | ||||||||
| FirstName: | LESLIE | ||||||||
| MiddleName: | FRANCIS | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 GUTHRIE SQ | ||||||||
| Address2: | |||||||||
| City: | SAYRE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 188401625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5708885858 | ||||||||
| FaxNumber: | 5708823007 | ||||||||
| Practice Location | |||||||||
| Address1: | 176 DENISON PKWY E | ||||||||
| Address2: | ANESTHESIA DEPARTMENT | ||||||||
| City: | CORNING | ||||||||
| State: | NY | ||||||||
| PostalCode: | 148302814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6079377200 | ||||||||
| FaxNumber: | 6079377860 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2006 | ||||||||
| LastUpdateDate: | 09/15/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 0024165574 | VA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 367500000X | 2831921 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.