MEDICARE: JOSEPH TRAPP RPA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	003080	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00687642	OTHER	NY	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861617839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH TRAPP RPA

Provider Business Mailing Address
First Line	:	PO BOX 304
Second Line	:
City	:	GLENS FALLS
State	:	NY
Zip	:	12801-0304
Country	:	US
Telephone Number	:	518-926-1935
Fax Number	:	518-926-4804

Provider Business Practice Location Address
First Line	:	135 NORTH RD
Second Line	:	WILTON FAMILY MEDICINE
City	:	WILTON
State	:	NY
Zip	:	12831-1308
Country	:	US
Telephone Number	:	518-926-1965
Fax Number	:	518-926-4804

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	09/12/2012

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Directions to “ JOSEPH TRAPP RPA” Practice Location

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