Provider Demographics
NPI:1386801801
Name:SMITH, AIMEE L (DO)
Entity type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:L
Last Name:SMITH
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:396 BROADWAY
Mailing Address - Street 2:FOXHALL LEVEL
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-4626
Mailing Address - Country:US
Mailing Address - Phone:845-334-2700
Mailing Address - Fax:845-338-0307
Practice Address - Street 1:1 FAMILY PRACTICE DR
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-6449
Practice Address - Country:US
Practice Address - Phone:845-338-6400
Practice Address - Fax:845-339-7288
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2014-08-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY254743207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03190310Medicaid
NY03190310Medicaid