Provider Demographics
NPI:1477717122
Name:SMYTHE, J ELIZABETH (RD, CDN, CPT)
Entity type:Individual
Prefix:MRS
First Name:J ELIZABETH
Middle Name:
Last Name:SMYTHE
Suffix:
Gender:F
Credentials:RD, CDN, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 BARRINGTON HLS
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4709
Mailing Address - Country:US
Mailing Address - Phone:585-734-3208
Mailing Address - Fax:
Practice Address - Street 1:20 BARRINGTON HLS
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-4709
Practice Address - Country:US
Practice Address - Phone:585-734-3208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X
NYRD874954133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist