MEDICARE: PATRICIA A PAPE PSYD

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	103T00000X	Psychologist	PY0003532	FL
2	103TC0700X	Clinical Psychologist	008021	NY

General Provider Information

NPI Number	:	1720169527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA A PAPE PSYD

Provider Business Mailing Address
First Line	:	240 1ST AVE
Second Line	:	#11D
City	:	NEW YORK
State	:	NY
Zip	:	10009-2601
Country	:	US
Telephone Number	:	561-329-9650
Fax Number	:	212-842-0818

Provider Business Practice Location Address
First Line	:	240 1ST AVE
Second Line	:	#11D
City	:	NEW YORK
State	:	NY
Zip	:	10009-2601
Country	:	US
Telephone Number	:	561-329-9650
Fax Number	:	212-842-0818

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

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	01/15/2015

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Directions to “ PATRICIA A PAPE PSYD” Practice Location

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