Provider Demographics
NPI:1952407181
Name:LAPHAM, PAULA (NP)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:LAPHAM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:
Other - Last Name:LAPHAM-TEDFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:210 CORNELIA ST
Mailing Address - Street 2:STE 305
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-2318
Mailing Address - Country:US
Mailing Address - Phone:518-562-7484
Mailing Address - Fax:518-562-7137
Practice Address - Street 1:210 CORNELIA ST
Practice Address - Street 2:STE 305
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-2318
Practice Address - Country:US
Practice Address - Phone:518-562-7484
Practice Address - Fax:518-562-7137
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF331784363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400032977Medicare UPIN
NYDD0503Medicare ID - Type Unspecified
NYP49140Medicare UPIN