Provider Demographics
NPI:1508820101
Name:LEFAUVE, SHARI (RPA-C)
Entity Type:Individual
Prefix:MRS
First Name:SHARI
Middle Name:
Last Name:LEFAUVE
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1945
Mailing Address - Country:US
Mailing Address - Phone:716-675-7693
Mailing Address - Fax:716-675-7782
Practice Address - Street 1:290 CENTER RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-1945
Practice Address - Country:US
Practice Address - Phone:716-675-7693
Practice Address - Fax:716-675-7782
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003659363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY003659OtherSTATE LICENSE NUMBER