Provider Demographics
NPI:1316994312
Name:SMITH, LESLIE FRANCIS (CRNA)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:FRANCIS
Last Name:SMITH
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 GUTHRIE SQ
Mailing Address - Street 2:
Mailing Address - City:SAYRE
Mailing Address - State:PA
Mailing Address - Zip Code:18840-1625
Mailing Address - Country:US
Mailing Address - Phone:570-888-5858
Mailing Address - Fax:570-882-3007
Practice Address - Street 1:176 DENISON PKWY E
Practice Address - Street 2:ANESTHESIA DEPARTMENT
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-2814
Practice Address - Country:US
Practice Address - Phone:607-937-7200
Practice Address - Fax:607-937-7860
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024165574367500000X
NY2831921367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered