Provider Demographics
NPI:1346200284
Name:LAPE, JEFFREY J (RPA)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:J
Last Name:LAPE
Suffix:
Gender:M
Credentials:RPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 W FAYETTE ST STE 400
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-2866
Mailing Address - Country:US
Mailing Address - Phone:315-937-3433
Mailing Address - Fax:315-449-1246
Practice Address - Street 1:5000 BRITTONFIELD PKWY STE A100
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9230
Practice Address - Country:US
Practice Address - Phone:315-449-3800
Practice Address - Fax:315-449-1246
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000489363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR55323Medicare UPIN
NY02508487Medicaid
NYCC8996Medicare ID - Type Unspecified
NYJ400038285Medicare PIN