Provider Demographics
NPI:1134121882
Name:PAGE, LINCOLN ESMAY (DPM)
Entity Type:Individual
Prefix:DR
First Name:LINCOLN
Middle Name:ESMAY
Last Name:PAGE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 MAXWELL RD
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-5123
Mailing Address - Country:US
Mailing Address - Phone:518-783-7668
Mailing Address - Fax:518-783-7668
Practice Address - Street 1:221 JEFFERSON HTS
Practice Address - Street 2:
Practice Address - City:CATSKILL
Practice Address - State:NY
Practice Address - Zip Code:12414-2111
Practice Address - Country:US
Practice Address - Phone:518-943-4642
Practice Address - Fax:518-943-4642
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002619-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY38468BMedicare ID - Type Unspecified