MEDICARE: PAULA LAPHAM N.P.

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	363LP2300X	Primary Care Nurse Practitioner	F331784	NY

General Provider Information

NPI Number	:	1952407181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA LAPHAM N.P.

Provider Business Mailing Address
First Line	:	210 CORNELIA ST
Second Line	:	STE 305
City	:	PLATTSBURGH
State	:	NY
Zip	:	12901-2318
Country	:	US
Telephone Number	:	518-562-7484
Fax Number	:	518-562-7137

Provider Business Practice Location Address
First Line	:	210 CORNELIA ST
Second Line	:	STE 305
City	:	PLATTSBURGH
State	:	NY
Zip	:	12901-2318
Country	:	US
Telephone Number	:	518-562-7484
Fax Number	:	518-562-7137

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

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	08/19/2013

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