Provider Demographics
NPI:1275522815
Name:PAPA, PHILIP M (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:M
Last Name:PAPA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:66 WINDSOR PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-5809
Mailing Address - Country:US
Mailing Address - Phone:718-768-2710
Mailing Address - Fax:718-768-0299
Practice Address - Street 1:66 WINDSOR PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-5809
Practice Address - Country:US
Practice Address - Phone:718-768-2710
Practice Address - Fax:718-768-0299
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYN005637213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPJ0221Medicare ID - Type Unspecified