Provider Demographics
NPI:1346331402
Name:L'EPISCOPO, JAMES WHALEN (PA)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:WHALEN
Last Name:L'EPISCOPO
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:46 WATER ST.
Mailing Address - Street 2:P.O. BOX 834
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:12932-0834
Mailing Address - Country:US
Mailing Address - Phone:518-873-7331
Mailing Address - Fax:
Practice Address - Street 1:75 PARK ST
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NY
Practice Address - Zip Code:12932
Practice Address - Country:US
Practice Address - Phone:518-873-6377
Practice Address - Fax:518-873-2091
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY003281-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR88486Medicare UPIN