Provider Demographics
NPI:1235122532
Name:PAPANDREA, LORA LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:LORA
Middle Name:LYNN
Last Name:PAPANDREA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PARKSIDE CT
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-5643
Mailing Address - Country:US
Mailing Address - Phone:315-724-6787
Mailing Address - Fax:315-735-6624
Practice Address - Street 1:3 PARKSIDE CT
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-5643
Practice Address - Country:US
Practice Address - Phone:315-724-6787
Practice Address - Fax:315-735-6624
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224746207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02279014Medicaid
NYH68059Medicare UPIN
NYDD2013Medicare ID - Type Unspecified