Provider Demographics
NPI:1629890884
Name:FUSINI SMITH, ARIEL (NP-BC)
Entity type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:FUSINI SMITH
Suffix:
Gender:F
Credentials:NP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 DEER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:POESTENKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12140-2308
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9 DEER CREEK RD
Practice Address - Street 2:
Practice Address - City:POESTENKILL
Practice Address - State:NY
Practice Address - Zip Code:12140-2308
Practice Address - Country:US
Practice Address - Phone:518-810-5849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF351303-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily